The impact of selective serotonin reuptake inhibitors on the thyroid function among patients with major depressive disorder: A systematic review and meta-analysis.

Publication date: Feb 08, 2020

Selective serotonin reuptake inhibitors (SSRI) have been claimed to negatively affect the thyroid function, albeit the evidence is controversial. We searched for studies that measured parameters of thyroid function (TSH, T4, Free T4, or T3) before and after a course of SSRI treatment in euthyroid patients with major depressive disorder. Electronic searches were conducted on MEDLINE, Embase and Web of Science databases from inception through April 4th, 2018. We performed random-effects meta-analyses to estimate the effect of SSRIs on each hormone. A total 1791 records were identified in the electronic search, and 14 observational clinical studies were included in the analyses. All studies had at least moderate risk of bias and were considered of low quality. A course of SSRI treatment was associated with a decrease in T4 of -6.58 nmol/L (95% Confidence Interval [CI], -12.17 to -.99, p = .005, I=97%; Cohen’s d = .50), a decrease in Free T4 of -.91 pmol/L (95% CI, -1.65 to -.16, p = .017, I=96%; Cohen’s d = .66), and a decrease in T3 of -.10 nmol/L (95% CI, -.18 to -.03, p = .007, I=96%; Cohen’s d = .45), and no effect on TSH (0.06 microIU/L, 95% CI, -.05 to .17, p = .285, I=98%; Cohen’s d = .17). We did not detect publication bias in any of the four meta-analyses. We conclude that there is preliminary evidence that SSRIs slightly decrease thyroid function, but quality of evidence is low. Clinical magnitude of such effect is yet unclear.

Caye, A., Pilz, L.K., Maia, A.L., Hidalgo, M.P., Furukawa, T.A., and Kieling, C. The impact of selective serotonin reuptake inhibitors on the thyroid function among patients with major depressive disorder: A systematic review and meta-analysis. 21013. 2020 Eur Neuropsychopharmacol.

Concepts Keywords
Confidence Interval Electronic search
Embase Major depressive disorder
Hormone Drugs
Magnitude RTT
Major Depressive Disorder Psychoactive drugs
MEDLINE Chemical compounds
Meta Analysis Major depressive disorder
Random Effects Antidepressant
Reuptake
Serotonin
SSRI
SSRIs
T4
Thyroid
TSH

Semantics

Type Source Name
drug DRUGBANK Serotonin
disease MESH major depressive disorder
disease MESH Hypothyroidism

Original Article

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