Thyroid Imipramine

Prange AJ Jr Paroxysmal auricular tachycardia apparently resulting from combined thyroid-imipramine treatment. Am J Psychiatry 119 994-995, 1963... 

Prange AJ, Wilson 1C, Rabon AM, et al Enhancement of imipramine antidepressant activity by thyroid hormone. Am J Psychiatry 126 457-468, 1969... 

Spurious hyperthyroidism occurred in a child taking thyroid hormone and imipramine for enuresis (89). The ability of thyroid hormone to increase receptor sensitivity to catecholamines has long been known, and has been used to enhance the clinical response in some refractory patients, especially women. 

Thyroid-Block potassium iodide Tofranil imipramine... 

The antidepressant response to imipramine, amitriptyline and possibly other tricyclics can be accelerated by the use of thyroid hormones. However, isolated cases of paroxysmal atrial tachycardia, thyrotoxicosis and hypothyroidism have occurred on concurrent use. 

The addition of liothyronine 25 micrograms daily was found to increase the speed and efficacy of imipramine in relieving depression. Similar results have been described in other studies with desipramine or amitriptyline but the reasons are not understood. One possible explanation is that the patients had overt or subclinical hypothyroidism, which after correction with liothyronine allowed them to overcome an impaired response to tricyclic antidepressants." However, adverse reactions have also been seen. A patient being treated for both hypothyroidism and depression with thyroid 60 mg and imipramine 150 mg daily complained of dizziness and nausea. She was found to have developed paroxysmal atrial tachycardia. A 10-year-old girl with congenital hypothyroidism, well controlled on desiccated thyroid 150 mg daily, developed severe thyrotoxicosis after taking imipramine 25 mg daily for 5 months for enuresis. The problem disappeared when the imipramine was withdrawn. In another patient the effect of levothyroxine was lost and hypothyroidism developed when dosulepin was started. ... 

Wilson IC, Prange AJ, McClane TK, Rabon AM, Lipton MA. Thyroid-hormone enhancement of imipramine in nonretarded depressions. NEnglJMed (1970) 282, 1063-7,... 

Colantonio LA, Orson JM. Triiodothyronine thyrotoxicosis. Induction by desiccated thyroid and imipramine. Aw JD/i" Child 91A) 128, 396-7. 

A preliminary clinical paper reported that high doses of L-tryptophan produced an antidepressive response similar to that elicited by imipramine.48 imipramine caused a decrease in the rate of disappearance of norepinephrine from the rat brain after a single intraperitoneal dose, but not after long-term administration by this route. This result may explain the delayed onset of action of the tricyclic antidepressives, and suggests that thyroid hormone or pharmacological agents that increase the turnover of norepinephrine in the brain, if... 

SUMMARY - The enhancement of the speed and efficacy of imipramine by the addition of thyroid hormone to the treatment program represents a promising develofanent in the control of depression. The apparent clinical failure of many new structures that exhibited high activity in one or more animal test procedures is indicative of the poor correlation between animal models and the complex nature of human depression. Biochemical, neuropharmacological and human pharmacological studies may yield new clues to the discovery of more effective, rapidacting, and less toxic antidepressives than those that are now available. 

Differences in the effects of acute and chronic treatment with imipramine and protriptyline on central NE metabolism in the rat have been observed. The turnover of NE was decreased after acute administration but increased during chronic administration of these drugs. The increase in NE turnover occurred sooner when thyroxine was administered with imipramine. It is suggested that these observations may help to explain the delayed onset of clinical antidepressive effects and the accelerating and enhancing effects of thyroid hormone on the clinical effects of imipramine. It has been suggested that thyroxine may exert some of its... 

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