Thyroxine augmentation of fluoxetine treatment for resistant depression in the elderly: An open trial

Yoram Barak*, Daniel Stein, Joseph Levine, Aliza Ring, Jack Hadjez, Avner Elizur, David Shoshani

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Drug resistant depression is a confounding entity. More so in populations of elderly depressives where addition of lithium or antidepressant combinations are possibly hazardous. We present an open-trial of thyroxine in elderly patients diagnosed as suffering from resistant depression. Methods - Thyroxine 50 mcg/day was added to fluoxetine 20 mg/day in patients who did not respond to previous, non-SSRI, antidepressant treatment (6 weeks), nor to an additional 6 weeks of fluoxetine. Subjects - Subjects were diagnosed as suffering from major depression, according to DSM-III-R criteria. All had normal thyroid function tests (TSH and FT4). There were 15 patients in our series: nine females, six males; mean age 72.1 years (± 6.5). Results - Patients depression severity was graded using the Hamilton Depression Rating Scale at baseline (before thyroxine augmentation), and 4 weeks after initiation of treatment. Ten of 15 patients responded to thyroxine augmentation (HDRS < 10), 3/15 showed no improvement of HDRS scores and two dropped out due to adverse effects: diarrhoea and tachycardia. Conclusions - Thyroxine augmentation of fluoxetine is effective in elderly subjects resistant to standard treatment, and is relatively safe.

Original languageEnglish
Pages (from-to)463-467
Number of pages5
JournalHuman Psychopharmacology
Issue number6
StatePublished - Nov 1996


FundersFunder number
Medical Research Council
Department of Health, Australian Government
Mauritius Research Council


    • depression
    • elderly
    • fluoxetine
    • thyroxine


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