David Baxter PhD
Late Founder
SSRI response boosted by hormone therapy after menopause
25 May 2007
Eur Neuropsychopharmacol 2007; 17: 400–405
Postmenopausal women with depression respond better to selective serotonin reuptake inhibitors (SSRIs) if they are also taking hormonal therapy (HT), Italian researchers suggest.
They also found that levels of luteinizing hormone (LH) may provide a means of predicting which women are likely to respond
The prevalence of major depression is greater in women than men, particularly between puberty and the end of reproductivity. Although postmenopausal women do not appear to be at greater risk of depression than their male peers, their low levels of estrogen are thought to reduce their response to SSRIs.
R Zanardi and colleagues from Vita-Salute University San Raffaele Hospital in Milan examined response to SSRIs in 170 postmenopausal women with a depressive episode, as defined by the DSM-IV criteria, 47 of whom were on HT.
Baseline serum levels of the gonadotropins LT and follicle-stimulating hormone (FSH) and those of estrogens and progestogens were determined, and the patients were started on SSRI treatment. They were reassessed after 7 weeks.
Among patients who were not also taking HT, the response rate to SSRIs was only 63.2%, compared with 83.7% among patients taking HT. Furthermore, the rates of remission were similar for the two groups, at 52.63% and 79.07%, respectively.
Baseline levels of FSH, estrogens, and progestogens were unrelated to SSRI response, but baseline levels of LH inversely correlated with improvements in Hamilton Rating Scale for Depression scores.
The researchers say in the journal European Neuropsychopharmacology: "In postmenopausal women, LH basal levels may be taken into account as possible predictors of response. Moreover, in our sample, HT significantly improved the response to SSRI antidepressants.
"Although the current indications for HT, given the associated risk factors, are to its use at the lowest possible dose for the shortest period of time to manage menopause-related symptoms, it may be useful to consider their favorable effects on the antidepressant response."
Free abstract
25 May 2007
Eur Neuropsychopharmacol 2007; 17: 400–405
Postmenopausal women with depression respond better to selective serotonin reuptake inhibitors (SSRIs) if they are also taking hormonal therapy (HT), Italian researchers suggest.
They also found that levels of luteinizing hormone (LH) may provide a means of predicting which women are likely to respond
The prevalence of major depression is greater in women than men, particularly between puberty and the end of reproductivity. Although postmenopausal women do not appear to be at greater risk of depression than their male peers, their low levels of estrogen are thought to reduce their response to SSRIs.
R Zanardi and colleagues from Vita-Salute University San Raffaele Hospital in Milan examined response to SSRIs in 170 postmenopausal women with a depressive episode, as defined by the DSM-IV criteria, 47 of whom were on HT.
Baseline serum levels of the gonadotropins LT and follicle-stimulating hormone (FSH) and those of estrogens and progestogens were determined, and the patients were started on SSRI treatment. They were reassessed after 7 weeks.
Among patients who were not also taking HT, the response rate to SSRIs was only 63.2%, compared with 83.7% among patients taking HT. Furthermore, the rates of remission were similar for the two groups, at 52.63% and 79.07%, respectively.
Baseline levels of FSH, estrogens, and progestogens were unrelated to SSRI response, but baseline levels of LH inversely correlated with improvements in Hamilton Rating Scale for Depression scores.
The researchers say in the journal European Neuropsychopharmacology: "In postmenopausal women, LH basal levels may be taken into account as possible predictors of response. Moreover, in our sample, HT significantly improved the response to SSRI antidepressants.
"Although the current indications for HT, given the associated risk factors, are to its use at the lowest possible dose for the shortest period of time to manage menopause-related symptoms, it may be useful to consider their favorable effects on the antidepressant response."
Free abstract
