{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T20:38:21Z","timestamp":1789763901350,"version":"4.0.1"},"reference-count":22,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2000,10,1]],"date-time":"2000-10-01T00:00:00Z","timestamp":970358400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2000,10]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>\n                      To describe a patient with longstanding depression and hypothyroidism who had marked mood improvement only after triiodothyronine (T\n                      <jats:sub>3<\/jats:sub>\n                      ) was added to her thyroxine (T\n                      <jats:sub>4<\/jats:sub>\n                      ) replacement therapy. CASE SUMMARY: A 50-year-old white woman had a long history of depression and documented hypothyroidism since 1991. Despite treatment with T\n                      <jats:sub>4<\/jats:sub>\n                      with dosages up to 0.3 mg\/d, she continued to be depressed, have symptoms of hypothyroidism, and have a persistently elevated thyroid-stimulating hormone concentration. Addition of a low dose of T\n                      <jats:sub>3<\/jats:sub>\n                      to her regimen resulted in significant mood improvement. DISCUSSION: The relationship between hypothyroidism and depression is well known. It is possible that this patient's long history of depression may have been a consequence of inadequately treated hypothyroidism, due either to poor patient compliance or resistance to T\n                      <jats:sub>4<\/jats:sub>\n                      . Nevertheless, her depression responded to addition of a low dose of T\n                      <jats:sub>3<\/jats:sub>\n                      to her regimen. This case emphasizes the importance of screening depressed patients for hypothyroidism. Her clinical course also suggests that depression related to hypothyroidism may be more responsive to a regimen that includes T\n                      <jats:sub>3<\/jats:sub>\n                      rather than to replacement with T\n                      <jats:sub>4<\/jats:sub>\n                      alone. This is consistent with the observation that T\n                      <jats:sub>3<\/jats:sub>\n                      is superior to T\n                      <jats:sub>4<\/jats:sub>\n                      as adjuvant therapy in the treatment of unipolar depression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      Depressed patients should be screened for hypothyroidism. In hypothyroid patients, depression may be more responsive to a replacement regimen that includes T\n                      <jats:sub>3<\/jats:sub>\n                      rather than T\n                      <jats:sub>4<\/jats:sub>\n                      alone. Therefore, inclusion of T\n                      <jats:sub>3<\/jats:sub>\n                      in the treatment regimen may be warranted after adequate trial with T\n                      <jats:sub>4<\/jats:sub>\n                      alone.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.10022","type":"journal-article","created":{"date-parts":[[2003,6,3]],"date-time":"2003-06-03T16:36:46Z","timestamp":1054658206000},"page":"1142-1145","source":"Crossref","is-referenced-by-count":23,"title":["Hypothyroidism and Depression: A Therapeutic Challenge"],"prefix":"10.1177","volume":"34","author":[{"given":"Sarah Kotchen","family":"Rack","sequence":"first","affiliation":[{"name":"Sarah Kotchen Rack MD, Assistant Professor, Department of Behavioral Medicine and Psychiatry, School of Medicine, West Virginia University, Morgantown, WV"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene H","family":"Makela","sequence":"additional","affiliation":[{"name":"Eugene H Makela PharmD, Associate Professor, Departments of Behavioral Medicine and Psychiatry, and Clinical Pharmacy, Schools of Medicine and Pharmacy, West Virginia University, Morgantown"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2000,10,1]]},"reference":[{"key":"bibr1-aph.10022","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)80050-5"},{"key":"bibr2-aph.10022","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.314.7088.1175"},{"key":"bibr3-aph.10022","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1995.tb00540.x"},{"key":"bibr4-aph.10022","first-page":"255","volume":"38","author":"Billewicz WZ","year":"1969","journal-title":"Q J Med"},{"key":"bibr5-aph.10022","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-8343(97)00060-1"},{"key":"bibr6-aph.10022","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.med.46.1.37"},{"key":"bibr7-aph.10022","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1997.00440310023002"},{"key":"bibr8-aph.10022","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199407213310307"},{"key":"bibr9-aph.10022","first-page":"47","volume":"54","author":"Howland RH","year":"1993","journal-title":"J Clin Psychiatry"},{"key":"bibr10-aph.10022","first-page":"205","volume":"33","author":"Esposito S","year":"1997","journal-title":"Psychopharmacol Bull"},{"key":"bibr11-aph.10022","first-page":"3194","volume":"83","author":"Pop VJ","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"bibr12-aph.10022","doi-asserted-by":"publisher","DOI":"10.1016\/0306-4530(92)90060-K"},{"key":"bibr13-aph.10022","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.126.4.457"},{"key":"bibr14-aph.10022","doi-asserted-by":"publisher","DOI":"10.1089\/thy.1996.6.63"},{"key":"bibr15-aph.10022","first-page":"21","volume":"52","author":"Nemeroff CB","year":"1991","journal-title":"J Clin Psychiatry"},{"key":"bibr16-aph.10022","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(90)90029-5"},{"key":"bibr17-aph.10022","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199902113400603"},{"key":"bibr18-aph.10022","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199409293311306"},{"key":"bibr19-aph.10022","doi-asserted-by":"publisher","DOI":"10.3928\/0048-5713-19971201-04"},{"key":"bibr20-aph.10022","first-page":"957","volume-title":"Psychopharmacology: the fourth generation of progress: an official publication of the American College of Neuropsychopharmacology","author":"Holsboer F","year":"1994"},{"key":"bibr21-aph.10022","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199304083281403"},{"key":"bibr22-aph.10022","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-123-8-199510150-00002"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.10022","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.10022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:02:37Z","timestamp":1777374157000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.10022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,10]]},"references-count":22,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2000,10]]}},"alternative-id":["10.1345\/aph.10022"],"URL":"https:\/\/doi.org\/10.1345\/aph.10022","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,10]]}}}