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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

PurposeTreatment-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 pati...

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Main Authors: Ludgate, Stephen (Author) , McGowan, Anne (Author) , Moran, Carla (Author) , Attanasio, Roberto (Author) , Žarković, Miloš (Author) , Nagy, Endre Vezekenyi (Author) , Negro, Roberto (Author) , Papini, Enrico (Author) , Adler Cohen, Chagit (Author) , Akarsu, Ersin (Author) , Alevizaki, Maria (Author) , Ayvaz, Göksun (Author) , Bednarczuk, Tomasz (Author) , Beleslin, Biljana Nedeljković (Author) , Berta, Eszter (Author) , Bodor, Miklos (Author) , Borissova, Anna Maria (Author) , Boyanov, Mihail (Author) , Buffet, Camille (Author) , Burlacu, Maria-Cristina (Author) , Ćirić, Jamina (Author) , Díez, Juan J. (Author) , Dobnig, Harald (Author) , Fadeyev, Valentin (Author) , Field, Benjamin C. T. (Author) , Fliers, Eric (Author) , Führer-Sakel, Dagmar (Author) , Galofré, Juan Carlos (Author) , Hakala, Tommi (Author) , Jiskra, Jan (Author) , Kopp, Peter A. (Author) , Krebs, Michael (Author) , Kršek, Michal (Author) , Kužma, Martin (Author) , Lazúrová, Ivica (Author) , Leenhardt, Laurence (Author) , Luchytskiy, Vitaliy (Author) , Melo, Miguel (Author) , Metso, Saara (Author) , Morgunova, Tatyana (Author) , Niculescu, Dan Alexandru (Author) , Perić, Božidar (Author) , Planck, Tereza (Author) , Poiana, Catalina (Author) , Marques Puga, Francisca (Author) , Robenshtok, Eyal (Author) , Rosselet, Patrick (Author) , Ruchala, Marek (Author) , Riis, Kamilla Ryom (Author) , Shepelkevich, Alla (Author) , Tronko, Mykola D. (Author) , Frølich, Jacob Stampe (Author) , Unuane, David (Author) , Vardarli, Irfan (Author) , Visser, W. Edward (Author) , Vryonidou, Andromachi (Author) , Younes, Younes Ramazan (Author) , Yurenya, Elena (Author) , Perros, Petros (Author) , Hegedüs, Laszlo (Author)
Format: Article (Journal)
Language:English
Published: 23 September 2025
In: Frontiers in endocrinology
Year: 2025, Volume: 16, Pages: 1-14
ISSN:1664-2392
DOI:10.3389/fendo.2025.1665720
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fendo.2025.1665720
Verlag, kostenfrei, Volltext: https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1665720/full
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Author Notes: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 and Laszlo Hegedüs

MARC

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245 1 4 |a 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  |c 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 and Laszlo Hegedüs 
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520 |a PurposeTreatment-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).MethodsThe question “Thyroid hormones may be indicated in biochemically euthyroid patients with treatment resistant depression” was posed to specialists from 28 countries.Results5695 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.ConclusionWhile 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. 
650 4 |a levothyroxine 
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