Thyroid hormone treatment in the management of treatment-resistant unipolar depression:A systematic review and meta-analysis

Autor:	Jesper Nørgaard Kjær, Søren Dinesen Østergaard, Rasmus Fink Lorentzen, Michael Moesmann Madsen
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	medicine.medical_specialty Thyroid Hormones Lithium (medication) treatment-resistant Placebo antidepressive agents 03 medical and health sciences Depressive Disorder Treatment-Resistant 0302 clinical medicine Thyroid Hormone Treatment depressive disorder Internal medicine Medicine Humans Depression (differential diagnoses) thyroid hormones Depressive Disorder Major business.industry Thyroid Odds ratio Antidepressive Agents 030227 psychiatry Psychiatry and Mental health medicine.anatomical_structure Meta-analysis Lithium Compounds Drug Therapy Combination business 030217 neurology & neurosurgery Hormone medicine.drug
Zdroj:	Lorentzen, R, Kjaer, J N, Østergaard, S D & Madsen, M M 2020, ' Thyroid hormone treatment in the management of treatment-resistant unipolar depression : A systematic review and meta-analysis ', Acta Psychiatrica Scandinavica, vol. 141, no. 4, pp. 316-326 . https://doi.org/10.1111/acps.13154
DOI:	10.1111/acps.13154
Popis:	BACKGROUND: Treatment with thyroid hormones is occasionally used in the management of treatment-resistant depression. However, the evidence supporting this treatment is not fully established. The aim of this study was to systematically review the literature on the effect of adjunctive thyroid hormone in the management of treatment-resistant unipolar depression and to provide a pooled estimate of its efficacy.METHODS: The study is registered with PROSPERO (reg. no. CRD42018108088) and followed the PRISMA guidelines. Searches were carried out on June 24th , 2019 in PubMed, EMBASE, and PsycINFO. Each record was screened independently by at least two reviewers. In instances of discrepancies, consensus was reached upon discussion. Pooled efficacy estimates were calculated based on response rates (decrease of ≥50% on the primary outcome measure) using random effect statistics.RESULTS: The search yielded 1355 records. Based on the screening of these records, we identified 10 studies that met the inclusion criteria (total number of patients = 663). The comparison of response to thyroid hormones versus placebo resulted in an odds ratio of 1.56 (95%CI: 0.50-4.84). Similarly, the comparison of response to thyroid hormones versus lithium resulted in an odds ratio of 1.91 (95%CI: 0.85-4.26). Thus, adjunctive therapy with thyroid hormones was not superior to placebo or lithium in the management of treatment-resistant unipolar depression.CONCLUSION: According to this review and meta-analysis, there is not sufficient evidence to support the use of adjunctive thyroid hormones for treatment-resistant unipolar depression.
Databáze:	OpenAIRE
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