Supraphysiological Doses of Levothyroxine as Adjunctive Therapy in Bipolar Depression
Status:
Completed
Trial end date:
2008-08-01
Target enrollment:
Participant gender:
Summary
There is growing evidence that thyroid axis dysfunction may contribute to the pathophysiology
of bipolar illness. Open-label studies have consistently demonstrated that the behavioral
expression of bipolar disorder can be modified by a change in thyroid status, and in many
instances the course of illness is improved through the use of adjunct thyroid hormone
treatment. Recent evidence emerged from acute intervention studies that add-on treatment with
supraphysiological doses of levothyroxine is an effective augmenting agent in patients with a
major depressive episode. The primary goal of this international multicenter trial (5 sites)
is to determine in a 13-week, randomized, placebo-controlled design (1 week single-blind
placebo run-in, 6 week double-blind, 6 week open-label) the efficacy and safety of add-on
treatment with levothyroxine (300 mcg/d) in combination with mood stabilizer/antidepressant
therapy in the treatment of patients with bipolar depression. The main hypotheses is:
treatment with levothyroxine will result in a significantly greater mean reduction of HRSD
total score and in a higher number of responders and remitters compared to placebo treatment.
This proposal will build on our pilot data and provide evidence for the use of levothyroxine
as an effective augmentation strategy in the treatment of bipolar depression.