Efficacy of Estradiol for the Treatment of Depressive Disorders in Perimenopausal Women

Soares, Cláudio de Novaes; Almeida, Osvaldo P.; Joffe, Hadine; Cohen, Lee S.

doi:10.1001/archpsyc.58.6.529

Cited by 604 publications

(134 citation statements)

References 39 publications

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“…There are numerous studies that have demonstrated the beneficial effects of oestrogen on mood in midlife women (52)(53)(54)(55). The Revised Global Consensus Statement on Menopausal Hormone Therapy (56) states that "MHT (menopausal hormone therapy) may be beneficial in improving mood in early postmenopausal women with depressive and/or anxiety symptoms.…”

Section: Treatmentmentioning

confidence: 99%

Depression in midlife women

Sassarini

2016

Maturitas

139

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Depression is one of the leading causes of disease-related disability in women, and they are nearly twice as likely as men to suffer from an episode of depression. The difference begins in early life and persists through to mid-life, and as such, these reproductive years have been labelled by some as a 'window of vulnerability'. The prevalence has been reported to be particularly high during the menopausal transition, but there is no consensus supporting a direct association with reproductive status. This may be partly due to methodological limitations and inconsistencies in the available studies, resulting from a large number of confounding factors. In addition, relationships between sex hormones and the neurotransmitters purported to be responsible for depression are complex. What appears to be universally accepted is that treatment, with oestrogen, for low mood in women during midlife years may be beneficial, and should be considered. Key Words Depression MidlifeSexual dimorphism Receptor polymorphisms SearchingAll searches were conducted in PUBMED and EMBASE. The following search terms were combined using Boolean rules: depression, menopause, midlife, women. All searches were updated June 2016.Searching of grey literature or unpublished literature was not undertaken. Papers published in languages other than English were not reviewed.The titles and abstracts of records retrieved by the searches were sifted for relevance, with potentially significant publications obtained in full text.

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Section: Treatmentmentioning

confidence: 99%

Depression in midlife women

Sassarini

2016

Maturitas

139

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“…Clinical studies indicate that E 2 may play a role in emotional behaviors [37,38,39,40,41,42]. We have demonstrated an ameliorative effect of E 2 in the forced swim test, a test for the efficacy of antidepressants [43].…”

Section: Introductionmentioning

confidence: 99%

Effects of Estrogen Treatment on Expression of Brain-Derived Neurotrophic Factor and cAMP Response Element-Binding Protein Expression and Phosphorylation in Rat Amygdaloid and Hippocampal Structures

Zhang

Cohen³

et al. 2005

Neuroendocrinology

127

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Clinical studies indicate an effect of estrogen (E₂) on affect and cognition, which may be mediated by the cAMP response element-binding protein (CREB) pathway and CREB-related gene target brain-derived neurotrophic factor (BDNF). We investigated the effect of E₂ on CREB expression and phosphorylation and BDNF expression in the amygdala and hippocampus, areas involved in emotional processing. Ovariectomized rats were given 10 µg 17β-estradiol or vehicle for 14 days and expression of components of the CREB signaling pathway, i.e., CREB, phosphorylated CREB (pCREB), and BDNF in amygdala and hippocampus were investigated using immunogold labeling. Levels of BDNF mRNA were determined by in situ reverse-transcriptase polymerase chain reaction. We also examined the effect of E₂ on calcium/calmodulin kinase (CaMK IV) immunolabeling in the hippocampus. E₂ increased immunolabeling and mRNA levels of BDNF in the medial and basomedial amygdala and CA1 and CA3 regions of the hippocampus, but not in any other amygdaloid or hippocampal regions examined. E₂ increased immunolabeling of CREB and pCREB in the medial and basomedial, but not central or basolateral amygdala. E₂ also increased CaMK IV and pCREB immunolabeling in the CA1 and CA3 regions, but not CA2 region or dentate gyrus, of the hippocampus. There was no change in immunolabeling of CREB in any hippocampal region. These data identify a signaling pathway through which E₂ increases BDNF expression that may underlie some actions of E₂ on affective behavior and indicate neuroanatomical heterogeneity in the E₂ effect within the amygdala and hippocampus.

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“…The question is especially relevant given the existing mixed results with various antidepressants [1, 2], the possibility of using other antidepressant classes, such as dual action drugs [3, 4], and the potential role of hormonal therapies (e.g. estradiol) for the treatment of menopause-related depressive symptoms [5, 6]. …”

Section: Introductionmentioning

confidence: 99%

Antidepressant Response and Well-Being in Pre-, Peri- and Postmenopausal Women with Major Depressive Disorder Treated with Fluoxetine

Cassano

Soares

Cusin

et al. 2005

Psychother Psychosom

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Background: We assessed the impact of menopausal status on treatment response and well-being in a cohort of outpatient women with major depressive disorder (DSM-III-R criteria), who received treatment with fluoxetine (20 mg/day for 8 weeks). Methods: Menopausal status was defined based on age, presence of menstrual irregularity or amenorrhea and vasomotor symptoms. Remission and response of depression were defined as a 17-item Hamilton Depression Rating Scale (HAM-D-17) score ≤7 and a HAM-D-17 decrease ≧50%, respectively. Well-being was assessed by self-rating with the Symptom Questionnaire. Remitters were followed up for 28 additional weeks. Results: No differences in rates of response and remission as well as in levels of well-being were observed among pre- (n = 121), peri- (n = 28) and postmenopausal (n = 35) women at the endpoint of the acute phase, even after adjustment for baseline depression severity. Residual symptoms, however, were significantly more common in postmenopausal women, except for the continuation phase endpoint. Differences in residual symptoms during the acute phase subsided after adjustment for baseline depression severity. Conclusions: Overall, menopausal status did not significantly affect the response to fluoxetine treatment and the degree of posttreatment well-being among major depressive disorder patients.

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Efficacy of Estradiol for the Treatment of Depressive Disorders in Perimenopausal Women

Abstract: Transdermal estradiol replacement is an effective treatment of depression for perimenopausal women.

Cited by 604 publications

References 39 publications

Depression in midlife women

Depression in midlife women

Effects of Estrogen Treatment on Expression of Brain-Derived Neurotrophic Factor and cAMP Response Element-Binding Protein Expression and Phosphorylation in Rat Amygdaloid and Hippocampal Structures

Antidepressant Response and Well-Being in Pre-, Peri- and Postmenopausal Women with Major Depressive Disorder Treated with Fluoxetine

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