The use of thyroid hormones in the treatment of euthyroid patients with treatment-resistant depression. Data from a survey of 5695 European national endocrine professional organization members
Year: 2025
Type: article
Study design: Observational Study
Abstract: Purpose: Treatment-resistant depression (TRD) is most commonly defined as depression that has not responded to two different pharmacological agents used for an adequate period of time. We explored the views of European specialists via survey, regarding the use of thyroid hormone (TH) in euthyroid patients with TRD as part of 'Treatment of Hypothyroidism in Europe by Specialists: An International Survey' (THESIS). Methods: The question "Thyroid hormones may be indicated in biochemically euthyroid patients with treatment resistant depression" was posed to specialists from 28 countries. Results: 5695 valid responses were received following 17,232 invitations (33.0% response rate; 65% female, 90% endocrinologists). 348 (6.1%) stated that TH may be indicated in biochemically euthyroid patients with TRD. This view was more common in males (p<0.01), respondents who saw ≥100 patients with hypothyroidism per year (p<0.01), respondents who worked in private practice (p=0.05) and respondents who were not members of international specialist associations (p=0.05). Geographical variation existed with respondents in Eastern Europe significantly more likely to use TH in TRD (p<0.01). Linear regression showed a statistically significant reduction in the use of TH for TRD with increasing gross national income (F-statistic=7.35, CI -0.15 - -0.02, p=0.01). TH in TRD was recommended in psychiatry guidelines but not endocrinology guidelines. Conclusion: While there is limited evidence for their use, over 6% of respondents stated that TH may be indicated in TRD. Due to the risk of iatrogenic thyrotoxicosis and increased morbidity the use of TH should be addressed in relevant endocrinology guidelines and consensus should be reached between specialties.
Source: Frontiers in Endocrinology
Authors: Stephen Ludgate, Anne McGowan, Carla Moran, Roberto Attanasio, Miloš Žarković, Endre Vezekenyi Nagy, Roberto Negro, Enrico Papini, Chagit Adler Cohen, Ersin Akarsu, Maria Alevizaki, Göksun Ayvaz, Tomasz Bednarczuk, Biljana Nedeljković Beleslin, Eszter Berta, Miklos Bodor, Anna Maria Borissova, Mihail Boyanov, Camille Buffet, Maria-Cristina Burlacu, Jamina Ćirić, Juan J. Díez, Harald Dobnig, Valentin Fadeyev, Benjamin C. T. Field, Eric Fliers, Dagmar Führer-Sakel, Juan Carlos Galofré, Tommi Hakala, Jan Jiskra, Peter A. Kopp, Michael Krebs, Michal Kršek, Martin Kužma, Ivica Lazúrová, Laurence Leenhardt, Vitaliy Luchytskiy, Miguel Melo, Saara Metso, Tatyana Morgunova, Dan Alexandru Niculescu, Božidar Perić, Tereza Planck, Catalina Poiana, Francisca Marques Puga, Eyal Robenshtok, Patrick Rosselet, Marek Ruchala, Kamilla Ryom Riis, Alla Shepelkevich, Mykola D. Tronko, Jacob Stampe Frølich, David Unuane, Irfan Vardarli, W. Edward Visser, Andromachi Vryonidou, Younes Ramazan Younes, Elena Yurenya, Petros Perros, Laszlo Hegedüs
Institutions: Trinity College Dublin, Tallaght University Hospital, University College Dublin, St. Vincent's University Hospital, University of Belgrade, University of Debrecen, University of Salento, Ospedale Vito Fazzi, Tel Aviv University, Rabin Medical Center, Gaziantep University, National and Kapodistrian University of Athens, Alexandra Hospital, Medical University of Warsaw, Sofia University "St. Kliment Ohridski", Alexandrovska Hospital, Medical University of Sofia, Sorbonne Université, Assistance Publique – Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Groupe de recherche clinique – Tumeurs Thyroïdiennes, Cliniques Universitaires Saint-Luc, UCLouvain, Hospital Universitario Puerta de Hierro Majadahonda, Universidad Autónoma de Madrid, Sechenov University, University of Surrey, Amsterdam University Medical Centers, University of Amsterdam, Essen University Hospital, University of Duisburg-Essen, Navarre Institute of Health Research, Clinica Universidad de Navarra, Tampere University Hospital, Charles University, General University Hospital in Prague, University of Lausanne, Medical University of Vienna, University Hospital Bratislava, Comenius University Bratislava, University of Pavol Jozef Šafárik, V.P. Komisarenko Institute of Endocrinology and Metabolism, National Academy of Medical Sciences of Ukraine, University of Coimbra, Carol Davila University of Medicine and Pharmacy, Skåne University Hospital, Poznan University of Medical Sciences, Odense University Hospital, Belarusian State Medical University, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Heidelberg University, Klinikum Vest, Knappschaftskrankenhaus Recklinghausen, Medizinische Fakultät Mannheim, Ruhr University Bochum, Erasmus MC, Hellenic Red Cross, Red Cross Hospital, East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Newcastle University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W4414444779