Effects of Long Term Treatment With Sertraline (Zoloft) Simulating Hypothyroidism in an Adolescent

A 16-year-old depressed adolescent, who had received sertraline treatment for the previous 18 months, developed insomnia, daytime somnolence, & lack of energy. He denied recent suicidal ideation or feelings of worthlessness or guilt. His thyroid function tests revealed low levels on total T4 with normal levels of free T4 & TSH, & a normal thyrotropin-releasing hormone stimulation test. Discontinuing sertraline resulted in improved sleep & the disappearance of daytime somnolence. (12 refs.)