DOES PROZAC AFFECT THYROID FUNCTION?
Depressed patients are first required to have a complete physical exam, an EKG, and a blood chemistry profile that measures, among other substances, the level of thyroid hormone. Because an amount below the normal range is sufficient in itself in some cases to cause depression, patients with underactive thyroids may need first and foremost to take thyroid medication. If the depression has not begun to disappear on thyroid hormone alone after seven to ten days, a trial of an antidepressant is initiated. However, if patients are already in a major depression superimposed on hypothyroidism, they may need an antidepressant as well as the thyroid hormone.
Fortunately, studies have shown no important interactions between Prozac and thyroid hormone. The two medications can be taken simultaneously. Thyroid hormone is usually given as levothyroxin. Cytomel or T3 (triiodothyronine) is given to boost the action of tricyclic antidepressants and used as a step-up treatment with Prozac if the antidepressant is not doing the job on its own.
To date, no clear-cut warning has been given regarding any important adverse effects of Prozac on the thyroid. Very infrequent cases of hypothyroidism have been reported with patients on Prozac. Even more rarely, goiter and hyperthyroidism have been reported, although they probably are not related to the Prozac treatment.
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