Effect of levothyroxine treatment on depression among newly diagnosed cases of hypothyroidism in adolescents at a tertiary care center

Abstract

Background: Depression in hypothyroidism has been studied in detail for the better part of two centuries now. The conditions share a lot of common symptoms and thus the term “brain hypothyroidism” has been used to understand the relationship better. Objective: The objective of this study was to study the effect of levothyroxine treatment on depression among newly diagnosed cases of hypothyroidism in adolescents. Materials and Methods: For this interventional study conducted between January 2021 and June 2022, cases were taken from the departments of general medicine, otorhinolaryngology, pediatrics, and psychiatry. Ninety-one individuals with diagnosed clinical hypothyroidism and no organomegaly with elevated thyroid-stimulating hormone (TSH) were taken and were asked to fill out the Hamilton Depression (HAM-D) Scale. The sample size came down to 64 after the initial assessment. They were treated with 25–50 μg of levothyroxine based on the body mass index and also given psychotherapy. The supplement of levothyroxine was weaned off after 12 weeks and the patients were asked to review after 4 weeks. Results: The average HAM-D score was found to be 21.81 before treatment and 9.71 after treatment. The average value of TSH before treatment was found to be 7.93 mIU/L and 4.32 mIU/L after treatment (P < 0.05). Depression associated with hypothyroidism in our study stood at 70.32%. After 12 weeks, the symptom score of HAM-D improved by 55.47%. In 41 out of 64 individuals, the signs of depression vanished. Conclusion: Depression is common in newly diagnosed cases of hypothyroidism and can be effectively managed without invasive medical intervention.

Keywords

• depression
• hypothyroidism
• hamilton depression scale
• levothyroxine