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Do you regularly prescribe TCAs for Depression?

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HarryMTieboutMD

I promise you if you do a Google scholar search for "synthroid bipolar depression" you will find papers. I might post a link a bit later if I have time.

no ****... I didn't say there wasn't literature on it (you could put on your PGY2 pants and pubmed it!); my point was that this is hardly standard or common practice (at least in the US).
 

clausewitz2

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no ****... I didn't say there wasn't literature on it (you could put on your PGY2 pants and pubmed it!); my point was that this is hardly standard or common practice (at least in the US).

Not sure why the need for the rudeness. You said you had never heard of any psychiatrist using t3 for this indication. I pointed out that a trivial search (I completed my PhD some years ago, I promise you I am aware of pubmed) would find you accounts of it being used for just this purpose. It's okay to be wrong or not fully informed sometimes, it is kind of inevitable for all of us. Getting angry at others who try and provide more info isn't super productive.

Totally in agreement with you that it is not standard practice. However, James Phelps is rather enamored of it, and if you don't know who he is, I can promise that many of your high-functioning bipolar patients who are Internet-savvy do. I expect you will have more patients in the future who are intensely interested in this opening, whether it is a great idea or not.

FWIW, this guy apparently treated 150 people with bipolar depression with T3: The use of triiodothyronine as an augmentation agent in treatment-resistant bipolar II and bipolar disorder NOS. - PubMed - NCBI
 
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HarryMTieboutMD

Not sure why the need for the rudeness. You said you had never heard of any psychiatrist using t3 for this indication. I pointed out that a trivial search (I completed my PhD some years ago, I promise you I am aware of pubmed) would find you accounts of it being used for just this purpose. It's okay to be wrong or not fully informed sometimes, it is kind of inevitable for all of us. Getting angry at others who try and provide more info isn't super productive.

Totally in agreement with you that it is not standard practice. However, James Phelps is rather enamored of it, and if you don't know who he is, I can promise that many of your high-functioning bipolar patients who are Internet-savvy do. I expect you will have more patients in the future who are intensely interested in this opening, whether it is a great idea or not.

FWIW, this guy apparently treated 150 people with bipolar depression with T3: The use of triiodothyronine as an augmentation agent in treatment-resistant bipolar II and bipolar disorder NOS. - PubMed - NCBI

You should prob go to (or step out of) your allocated residency safe space and read about the perplexing conundrum of how T3, T4, Cytomel, Synthroid, liothyroinine, levothyroxine all relate to each other
 

clausewitz2

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You should prob go to (or step out of) your allocated residency safe space and read about the perplexing conundrum of how T3, T4, Cytomel, Synthroid, liothyroinine, levothyroxine all relate to each other


My bad, I conflated your post with the one upthread expressing amazement at using T3. I mean, still, the point about there definitely being folks in practice advocating for it's use remains, especially Phelps and co, but I guess it's more fun to accuse me of being unable to tolerate...something, not sure what?

I am hitting some kind of nerve, clearly, so I will back off. You obviously know a lot, no doubt about it, not something you need to be insulting about to prove. I am gonna give you the benefit of the doubt as a reasonable person and assume it is Saturday night and you have had a few drinks.
 

PistolPete

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When you guys use T3 as an adjunct and get remission, how long do you continue the T3? I've never used it as an adjunct, and I'm thinking about the potential disturbance of TSH with chronic use.
 
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HarryMTieboutMD

When you guys use T3 as an adjunct and get remission, how long do you continue the T3? I've never used it as an adjunct, and I'm thinking about the potential disturbance of TSH with chronic use.
I keep it as long as it continues to work and there aren't problems. I just ask about thyroid symptoms and check TSH every 6 months
 
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