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CompletedNCT01528839Updated Feb 8, 2012

Supraphysiological Doses of Levothyroxine as Adjunctive Therapy in Bipolar Depression

A Phase 2/3 interventional study of L-Thyroxine and Placebo in Bipolar Disorder, sponsored by Charite University, Berlin, Germany. Completed at 5 sites in 2 countries. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2012-02-08.

Sponsored by Charite University, Berlin, Germany · Phase 2/3, Interventional, and Treatment

Phase
Phase 2/3
Study type
Interventional
Enrollment
74
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

There is growing evidence that thyroid axis dysfunction may contribute to the pathophysiology of bipolar illness. Open-label studies have consistently demonstrated that the behavioral expression of bipolar disorder can be modified by a change in thyroid status, and in many instances the course of illness is improved through the use of adjunct thyroid hormone treatment. Recent evidence emerged from acute intervention studies that add-on treatment with supraphysiological doses of levothyroxine is an effective augmenting agent in patients with a major depressive episode. The primary goal of this international multicenter trial (5 sites) is to determine in a 13-week, randomized, placebo-controlled design (1 week single-blind placebo run-in, 6 week double-blind, 6 week open-label) the efficacy and safety of add-on treatment with levothyroxine (300 mcg/d) in combination with mood stabilizer/antidepressant therapy in the treatment of patients with bipolar depression. The main hypotheses is: treatment with levothyroxine will result in a significantly greater mean reduction of HRSD total score and in a higher number of responders and remitters compared to placebo treatment. This proposal will build on our pilot data and provide evidence for the use of levothyroxine as an effective augmentation strategy in the treatment of bipolar depression.

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Conditions studied

  • Bipolar Disorder

Keywords

  • Bipolar disorder
  • Bipolar depression
  • Thyroid abnormality
  • mood stabilizer
  • antidepressants
  • currently depressed
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In context

Depression

8,057 studies on the registry are indexed under Depression; 1,641 are open to participants now.

This study's enrollment of 74 is below the median of 84 across 6,720 interventional studies indexed under Depression.

Browse Depression studies →

Lead sponsor

Charite University, Berlin, Germany is the lead sponsor of 836 studies on the registry; 129 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Diagnosis of bipolar I or II disorder, currently depressive episode according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)
  • Hamilton Rating Scale for Depression (HAM-D) 17-item score ≥14, a HAM-D item 1 (depressed mood) score ≥2 at the screening and randomization visits
  • Young Mania Rating Scale (YMRS) score ≤12 at the screening and randomization visits.
  • Pretreatment with a mood stabilizer and/or an antidepressant at standard doses (Bauer et al. 2007a) for at least six weeks since the last dose adjustment, and for at least two weeks before enrollment
  • Serum levels of mood stabilizer were required to be within therapeutic ranges
  • TSH levels in normal range (serum TSH 0.3 - 4.7 mU/l)

Exclusion criteria

Exclusion Criteria:

  • Any axis I disorder other than bipolar disorder
  • Recent ultra-rapid cycling course (12 or more episodes in previous year), - - a diagnosis of substance dependence (DSM-IV) or substance use (except for nicotine) within 12 months before the screening visit
  • Clinically significant medical illness, especially severe cardiovascular diseases
  • Organic brain disorder
  • Current serious suicidal or homicidal risk by clinical judgment of the investigator
  • History of previous or current thyroid disease
  • Thyroid hormone treatment
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Study design

Phase
Phase 2 / Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
74 participants (actual)

Study arms

  • Placebo comparator
    Pill

    Drug: Placebo

  • Experimental
    L-Thyroxine as addon

    Drug: L-Thyroxine

Interventions

  • DrugL-Thyroxine

    L-Thyroxine as addon to ongoing stable antidepressant and /or mood stabilizing therapy: week 1: 100 mcg; week 2: 200 mcg: week 3 to week 6: 300 mcg

  • DrugPlacebo
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What researchers measure

Primary outcomes

  1. Mean change in Hamilton Rating Scale for Depression (HRSD, 17 items)

    Time frame: baseline and six weeks

Secondary outcomes

  1. Mean change and single items change in the Thyroid Symtom List (TSL)

    Time frame: baseline and six weeks

  2. Remission/Response

    Rate of Resonders (\>50% decline in HRDS) and Remitters (HRDS- score \< 9)after l-Thyroxine addon treatment

    Time frame: six weeks

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Study locations

5 sites
  • University of California in Los Angeles
    Los Angeles, California, United States
  • Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
    Berlin, Germany
  • Department of Psychiatry, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
    Bochum, Germany
  • Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
    Dresden, Germany
  • Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
    Göttingen, Germany
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References and documents

Publications

  • Pilhatsch M, J Stamm T, Stahl P, Lewitzka U, Berghofer A, Sauer C, Gitlin M, Frye MA, Whybrow PC, Bauer M. Treatment of bipolar depression with supraphysiologic doses of levothyroxine: a randomized, placebo-controlled study of comorbid anxiety symptoms. Int J Bipolar Disord. 2019 Oct 4;7(1):21. doi: 10.1186/s40345-019-0155-y. PubMed 31583561 ↗
  • Stamm TJ, Lewitzka U, Sauer C, Pilhatsch M, Smolka MN, Koeberle U, Adli M, Ricken R, Scherk H, Frye MA, Juckel G, Assion HJ, Gitlin M, Whybrow PC, Bauer M. Supraphysiologic doses of levothyroxine as adjunctive therapy in bipolar depression: a randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2014 Feb;75(2):162-8. doi: 10.4088/JCP.12m08305. PubMed 24345793 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 8, 2012, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT01528839
Lead sponsor
Charite University, Berlin, Germany
Collaborators
Stanley Medical Research Institute
Responsible party
Thomas Stamm (Associate Director Mood Disorders Research Group Department of Psychiatry and Psychotherapy CCM, Charite University, Berlin, Germany) — Principal investigator
First posted
Feb 8, 2012
Start date
Mar 2004
Primary completion
May 2008
Completion
Aug 2008
Last update
Feb 8, 2012

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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