The Experts below are selected from a list of 27 Experts worldwide ranked by ideXlab platform

A Groeppelin - One of the best experts on this subject based on the ideXlab platform.

Russell T Joffe - One of the best experts on this subject based on the ideXlab platform.

  • triiodothyronine augmentation in the treatment of refractory depression a meta analysis
    Archives of General Psychiatry, 1996
    Co-Authors: R Aronson, Russell T Joffe, H J Offman, C D Naylor
    Abstract:

    Background: Several trials have addressed the efficacy of Liothyronine Sodium therapy in euthyroid, nonpsychotic depressed patients refractory to tricyclic antidepressant therapy. We undertook a meta-analysis of these trials. Methods: The MEDLINE database (1966 to May 1995) and published reference lists were examined for controlled clinical trials of triiodothyronine augmentation in euthyroid patients with refractory depression. Quality assessment and data abstraction were performed independently by two reviewers. Results were aggregated three ways: the relative response rate compared with controls, accepting each trial's definition of clinical response; absolute improvement in response rates; and improvements in depression scores, analyzed as continuous variables without a prespecified threshold for clinical response. Results: Aggregating eight studies with a total of 292 patients, patients treated with triiodothyronine augmentation were twice as likely to respond as controls (relative response, 2.09; 95% confidence interval [CI], 1.31 to 3.32; P =.002). This corresponded to a 23.2% absolute improvement in response rates (95% CI, 4.5% to 41.9%; P =.02). Improvements in depression scores were moderately large (standardized effect size, 0.62; P P =.29), but one study with negative results accounted for most of the intertrial heterogeneity in results. Conclusions: Triiodothyronine augmentation may be an effective empirical method of increasing response rates and decreasing depression severity scores in a subgroup of patients with depression refractory to tricyclic antidepressant therapy, but the total number of patients randomized was small, and additional placebo-controlled data are required for a definitive verdict. Since therapeutic trends now favor other drugs, future trials might usefully examine triiodothyronine augmentation with selective serotonin reuptake inhibitors or compare potentiation strategies, eg, lithium vs triiodothyronine, for managing refractory depression. Such trials would benefit from much larger sample sizes than those reviewed here.

  • a placebo controlled comparison of lithium and triiodothyronine augmentation of tricyclic antidepressants in unipolar refractory depression
    Archives of General Psychiatry, 1993
    Co-Authors: Russell T Joffe, William Singer, Anthony J Levitt, Cathy Macdonald
    Abstract:

    Objective: To directly compare the efficacy of lithium carbonate and Liothyronine Sodium (triiodothyronine) in the augmentation of therapeutic response in antidepressant nonresponders. Design: A randomized, double-blind, placebocontrolled study of 2 weeks' duration. Setting: The Mood Disorders Program, Clarke Institute of Psychiatry and the University of Toronto, Ontario. Patients: Fifty outpatients, males and females, with unipolar, nonpsychotic major depression who had failed to respond to treatment with desipramine hydrochloride or imipramine hydrochloride. Results: Both Liothyronine and lithium were more ef- fective than placebo in reducing scores on the Hamilton Rating Scale for Depression. However, the antidepressant augmenting effect of these two compounds did not differ from each other. When response was defined as a 50% or more reduction in the Hamilton Rating Scale for Depression scores and a final score less than 10, we found that 10 of 17 subjects responded to Liothyronine, nine of 17 responded to lithium and three of 16 responded to placebo. Conclusions: Our study suggests that both lithium and Liothyronine may be considered as alternatives in augmenting antidepressant response in patients who do not respond to treatment with a tricyclic antidepressant.

C D Naylor - One of the best experts on this subject based on the ideXlab platform.

  • triiodothyronine augmentation in the treatment of refractory depression a meta analysis
    Archives of General Psychiatry, 1996
    Co-Authors: R Aronson, Russell T Joffe, H J Offman, C D Naylor
    Abstract:

    Background: Several trials have addressed the efficacy of Liothyronine Sodium therapy in euthyroid, nonpsychotic depressed patients refractory to tricyclic antidepressant therapy. We undertook a meta-analysis of these trials. Methods: The MEDLINE database (1966 to May 1995) and published reference lists were examined for controlled clinical trials of triiodothyronine augmentation in euthyroid patients with refractory depression. Quality assessment and data abstraction were performed independently by two reviewers. Results were aggregated three ways: the relative response rate compared with controls, accepting each trial's definition of clinical response; absolute improvement in response rates; and improvements in depression scores, analyzed as continuous variables without a prespecified threshold for clinical response. Results: Aggregating eight studies with a total of 292 patients, patients treated with triiodothyronine augmentation were twice as likely to respond as controls (relative response, 2.09; 95% confidence interval [CI], 1.31 to 3.32; P =.002). This corresponded to a 23.2% absolute improvement in response rates (95% CI, 4.5% to 41.9%; P =.02). Improvements in depression scores were moderately large (standardized effect size, 0.62; P P =.29), but one study with negative results accounted for most of the intertrial heterogeneity in results. Conclusions: Triiodothyronine augmentation may be an effective empirical method of increasing response rates and decreasing depression severity scores in a subgroup of patients with depression refractory to tricyclic antidepressant therapy, but the total number of patients randomized was small, and additional placebo-controlled data are required for a definitive verdict. Since therapeutic trends now favor other drugs, future trials might usefully examine triiodothyronine augmentation with selective serotonin reuptake inhibitors or compare potentiation strategies, eg, lithium vs triiodothyronine, for managing refractory depression. Such trials would benefit from much larger sample sizes than those reviewed here.

Cathy Macdonald - One of the best experts on this subject based on the ideXlab platform.

  • a placebo controlled comparison of lithium and triiodothyronine augmentation of tricyclic antidepressants in unipolar refractory depression
    Archives of General Psychiatry, 1993
    Co-Authors: Russell T Joffe, William Singer, Anthony J Levitt, Cathy Macdonald
    Abstract:

    Objective: To directly compare the efficacy of lithium carbonate and Liothyronine Sodium (triiodothyronine) in the augmentation of therapeutic response in antidepressant nonresponders. Design: A randomized, double-blind, placebocontrolled study of 2 weeks' duration. Setting: The Mood Disorders Program, Clarke Institute of Psychiatry and the University of Toronto, Ontario. Patients: Fifty outpatients, males and females, with unipolar, nonpsychotic major depression who had failed to respond to treatment with desipramine hydrochloride or imipramine hydrochloride. Results: Both Liothyronine and lithium were more ef- fective than placebo in reducing scores on the Hamilton Rating Scale for Depression. However, the antidepressant augmenting effect of these two compounds did not differ from each other. When response was defined as a 50% or more reduction in the Hamilton Rating Scale for Depression scores and a final score less than 10, we found that 10 of 17 subjects responded to Liothyronine, nine of 17 responded to lithium and three of 16 responded to placebo. Conclusions: Our study suggests that both lithium and Liothyronine may be considered as alternatives in augmenting antidepressant response in patients who do not respond to treatment with a tricyclic antidepressant.

M Andre - One of the best experts on this subject based on the ideXlab platform.