SSRI Antidepressants for Thyroid Patients
When Hormone Therapy Does Not Improve Emotional Symptoms
Sep 3, 2009
Getting thyroid hormones back into balance when the thyroid is overactive or under-active can go a long way toward relieving symptoms of anxiety and/or depression. For some thyroid patients however, emotional symptoms will linger even after adequate or optimal treatment is administered for their thyroid disorder. SSRI antidepressants are often the treatment that is added to address stubborn emotional symptoms.
Emotional Symptoms Associated With Thyroid Autoimmunity
According to medical research published on the PubMed website (U.S. Gov.-National Institutes of Health), anxiety and mood disorders can be directly related to “anti-thyroidperoxidase auto-antibodies” (anti-TPO). These are the antibodies found in most cases of thyroid diseases caused by an immune system response, in which they are sent to attack protein/enzymes in the thyroid gland.
One particular study entitled “The link between thyroid autoimmunity (antithyroid peroxidase autoantibodies) with anxiety and mood disorders in the community: a field of interest for public health in the future”, states that psychiatric disorders in thyroid patients may be rooted in the “thyroid autoimmunity” and not easily correctable. There are a number of other studies with similar conclusions. These type studies demonstrate the fact that correcting thyroid hormone imbalances does not treat or halt the disease process itself and therefore symptoms such as the emotional ones may need additional treatments.
SSRI Antidepressants Can Decrease Thyroid Hormones
SSRI stands for “selective serotonin reuptake inhibitors” and is the most commonly prescribed type of antidepressant, for both anxiety and depression symptoms. Medical research studies have found that SSRI antidepressants can cause a slight decrease in both the T3 and T4 thyroid hormone levels. In one study, this conclusion came after trials of the drug were given to 19 patients with major depression and their blood baseline thyroid hormone levels before the trial were compared to their retested levels following the drug treatment and post-treatment levels were significantly lowered by the drug.
The research study titled “Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors” also mentions the fact that keeping thyroid hormone levels at “optimal” range in patients treated with SSRI drugs can increase the effectiveness of antidepressant treatment. This is mentioned despite the fact that the participants used in the drug trial were not thyroid patients. This would seem to indicate even more importance in treated thyroid patients having optimal thyroid hormone levels to aid in SSRI antidepressant treatment.
Adjusting the Thyroid Hormone Therapy Dose
With the fact that an SSRI drug may decrease a treated hypothyroid patient’s thyroid hormone levels, a treating doctor may want to retest a patient being treated with the drug, to see what hormone dose adjustments might be needed. If a patient has been on thyroid hormone therapy long enough to only require blood retesting of their hormone levels every three to six months, adding an SSRI antidepressant might require that the blood retest scheduling be shortened.
The blood retesting typically used in newly treated hypothyroid patients, which would be about every 8-weeks, might be a good idea until an antidepressant has also fully adjusted in the body. This way the doctor can see if the drug has any lowering affect on thyroid hormone levels, so that they can be raised accordingly. Optimizing treatment for hypothyroidism may lend toward greater success in treating emotional symptoms with SSRI antidepressants.
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