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Thyrotropin, but not a polymorphism in type II deiodinase, predicts response to paroxetine in major depression.

Author(s): Brouwer JP, Appelhof BC, Peeters RP, Hoogendijk WJ, Huyser J, Schene AH, Tijssen JG, Van Dyck R, Visser TJ, Wiersinga WM, Fliers E

Affiliation(s): Department of Endocrinology, Academic Medical Center, The Netherlands. j.p.brouwer@amc.uva.nl

Publication date & source: 2006-06, Eur J Endocrinol., 154(6):819-25.

Publication type: Randomized Controlled Trial

OBJECTIVE: The determinants of response to antidepressant treatment in major depression are unknown at present. The aim of the present study was to establish whether response is predicted by Hypothalamus-Pituitary-Thyroid (HPT) axis parameters or by a recently discovered polymorphism in the enzyme type II deiodinase (DII), which catalyzes the production of T3 in the brain. DESIGN: We analyzed prediction of response to paroxetine treatment by calculating response rates per tertile of HPT-axis parameters and per DII genotype. METHODS: Ninety-eight outpatients with major depression (DSM-IV) were included. Serum concentrations of TSH, FT4 and delta TSH in a DEX/CRH-TRH test were measured. In addition, the presence of a polymorphism in the DII sequence (Thr92Ala) was determined. RESULTS: The overall treatment response was 48 of 98 patients (49%). After exclusion of patients with subclinical hypothyroidism and/or TPO antibodies (n = 16), higher serum TSH significantly predicted response (response rate per tertile from low to high TSH: 36%, 42%, and 67%). Heterozygous patients for the DII polymorphism (44%) had slightly lower serum TSH (P = 0.03) as compared to patients with the wild-type DII (47%). The polymorphism was unrelated to treatment response. CONCLUSION: Higher serum TSH was associated with response to paroxetine in patients with major depression.

Page last updated: 2006-11-04

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