Combined Treatment With Sertraline and Liothyronine in Major Depression

CYTOMED 25 (Liothyronine Sodium T3) contains a synthetic form of the natural thyroid hormone triiodothyronine (T3), as the sodium salt.T3 contains three atoms of iodine and is formed by the coupling of one molecule of DIT with one molecule of monoiodotyrosine (MIT). It should be understood that there is a difference between Liothyronine Sodium and the human body's own natural endogenously manufactured thyroid hormone is known as Triiodothyronine. Liothyronine is the L-isomer of Triiodothyronine. Liothyronine and Triiodothyronine are both nearly identical with one another, but Liothyronine is a more potent variant and is also better absorbed orally.

Liothyronine Sodium T3 is used for the treatment of Major Depression. Antidepressant medications are widely used for the treatment of the major depressive disorder (MDD), a severe and highly prevalent illness that has a significant impact on public health all over the world. A major depressive disorder is successfully treated with selective serotonin reuptake inhibitors (SSRIs), the most frequently used first-line agents, may require up to 8 weeks. Full remission is achieved in fewer than 50% of patients. Today, the medical community is searching for new antidepressant treatments that achieve a higher remission rate than those which are currently available. The thyroid hormone triiodothyronine may potentiate antidepressant effects.

Double-blind, randomized, 8-week, placebo-controlled trial was performed to determine the antidepressant efficacy and safety of liothyronine sodium (triiodothyronine) when administered concurrently with the selective serotonin reuptake inhibitor sertraline hydrochloride to patients with major depressive disorder.

The present study was conducted using the following methodology: a total of 124 adult outpatients meeting unmodified DSM-IV criteria for the major depressive disorder without psychotic features participated in the research. Patients were randomized in two groups, to receive either sertraline hydrochloride (50 mg/d for 1 week; 100 mg/d thereafter) and liothyronine sodium (20-25 μg/d for 1 week; 40-50 μg/d thereafter) or sertraline and placebo for 8 weeks.

The main outcome measure was a categorical response to treatment (≥50% decrease in scores on the 21-item Hamilton Rating Scale for Depression from baseline to study endpoint). The secondary outcome measure was a remission rate (final Hamilton Rating Scale for Depression score, ≤6).

Following results were achieved: intent-to-treat Hamilton Rating Scale for Depression response rates were 70% and 50% in the sertraline-liothyronine and sertraline-placebo groups, respectively (P = .02; odds ratio, 2.93; 95% confidence interval, 1.23-7.35); remission rates were 58% with sertraline-liothyronine and 38% with sertraline-placebo (P = .02; odds ratio, 2.69; 95% confidence interval, 1.16-6.49). Baseline T₃ values were lower in patients treated with sertraline-liothyronine who had remissions than in those without remissions (t₄₈ = 3.36; P<.002). Among patients treated with sertraline-liothyronine, remission was associated with a significant decrease in serum thyrotropin values (F1,73 = 4.00; P<.05). There were no significant effects noticed of liothyronine supplementation on the frequency of side effects.

The results of the study demonstrate enhancement of the antidepressant effect of sertraline by concurrent treatment with liothyronine without a significant increase in adverse effects. The antidepressant effect of liothyronine may be directly linked to thyroid function.