T3 Treats Bipolar Disorder

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T3 treats major depressive disorder (MDD), and hypothyroidism appears alongside various neuroses including generalized anxiety disorder (GAD), phobias including social anxiety disorder (SAD), personality disorders (which often feature elevated cortisol and low DHEA), and lastly obsessive-compulsive disorder (OCD).
This study shows that T3 can also treat bipolar disorder, both by itself or in conjunction with a drug such as lithium (with actions similar to sodium) or other anticonvulsants (such as lamotrigine).
“Patients had been unsuccessfully treated with an average of 14 other medications before starting T3. At an average dose of 90.4 mcg (range 13 mcg-188 mcg) the medication was well tolerated. None of the patients experienced a switch into hypomania, and only 16 discontinued due to side effects. Improvement was experienced by 84%, and 33% experienced full remission.
A high percentage of bipolar II and bipolar NOS patients with treatment resistant depression improved on T3. Despite the use of higher than usual doses in many of the patients, the medication was well tolerated. Augmentation with supraphysiologic doses of T3 should be considered in cases of treatment resistant bipolar depression.
SOURCE: https://www.ncbi.nlm.nih.gov/pubmed/19215985

Pregnenolone has powerful antidepressive effects, and there’s evidence for its effectiveness in bipolar depression.

500 milligrams of pregnenolone, when administered by mouth daily for 12 weeks, decreased depressive symptoms by almost 2/3:

“Depression remission rates were greater in the pregnenolone group (61%) compared with the placebo group (37%).”

Pregnenolone enhanced allopregnenolone levels (SSRIs and other antidepressants work on identical pathways in the brain):

“Large baseline-to-exit changes in neurosteroid levels were observed in the pregnenolone group but not in the placebo group. In the pregnenolone group, baseline-to-exit change in the HRSA correlated negatively with changes in allopregnanolone (r(22)=-0.43, p=0.036) and pregNANolone (r(22)=-0.48, p=0.019) levels.”

The researchers affirmed the safety and effectiveness of pregnenolone:

“Pregnenolone was well tolerated. The results suggest that pregnenolone may improve depressive symptoms in patients with BPD and can be safely administered.”

Georgi Dinkhov,posted this study on the Ray Peat Forum.

References

Brown, E. S., Park, J., Marx, C. E., Hynan, L. S., Gardner, C., Davila, D., … Holmes, T. (2014). A randomized, double-blind, placebo-controlled trial of pregnenolone for bipolar depression. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 39(12), 2867–2873. https://doi.org/10.1038/npp.2014.138

Depression in bipolar disorder (BPD) is challenging to treat. Therefore, additional medication options are needed. In the current report, the effect of the neurosteroid pregnenolone on depressive symptoms in BPD was examined. Adults (n=80) with BPD, depressed mood state, were randomized to pregnenolone (titrated to 500 mg/day) or placebo, as add-on therapy, for 12 weeks. Outcome measures included the 17-item Hamilton Rating Scale for Depression (HRSD), Inventory of Depressive Symptomatology-Self-Report (IDS-SR), Hamilton Rating Scale for Anxiety (HRSA), and Young Mania Rating Scale (YMRS). Serum neurosteroid levels were assessed at baseline and week 12. Data were analyzed using a mixed model ANCOVA with a between factor of treatment assignment, a within factor (repeated) of visit, and the baseline value, as well as age and gender, as covariates. In participants with at least one postbaseline visit (n=73), a significant treatment by week interaction for the HRSD (F(5,288)=2.61, p=0.025), but not IDS-SR, was observed. Depression remission rates were greater in the pregnenolone group (61%) compared with the placebo group (37%), as assessed by the IDS-SR (χ(2)(1)=3.99, p=0.046), but not the HRSD. Large baseline-to-exit changes in neurosteroid levels were observed in the pregnenolone group but not in the placebo group. In the pregnenolone group, baseline-to-exit change in the HRSA correlated negatively with changes in allopregnanolone (r(22)=-0.43, p=0.036) and pregNANolone (r(22)=-0.48, p=0.019) levels. Pregnenolone was well tolerated. The results suggest that pregnenolone may improve depressive symptoms in patients with BPD and can be safely administered.

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