Estrogen replacement in perimenopause-related depression: a preliminary report.
OBJECTIVE
We examined the efficacy of estrogen in the treatment of depression in perimenopausal women with and without hot flushes.


METHODS
Women with perimenopause-related depression were randomized in a double-blind parallel design to receive either 17beta-estradiol or placebo for 3 weeks. Subsequently, women receiving estradiol during the first 3 weeks continued receiving estradiol for an additional 3 weeks, whereas women who had received placebo crossed over to estradiol for 3 weeks. Outcome measures included standardized mood rating scales and a visual analog scale self-report instrument.


RESULTS
Of 34 female subjects, 16 received estradiol first and 18 received placebo first. After 3 weeks of estradiol, standardized mood rating scale scores and visual analog scale symptom scores (eg, sadness, anhedonia, and social isolation) were significantly decreased compared with baseline scores (P <.01) and were significantly lower than scores in women receiving placebo (P <.01), who showed no significant improvement. Neither the presence of hot flushes nor the duration of treatment (3 weeks vs 6 weeks) influenced outcome. A full or partial therapeutic response was seen in 80% of subjects receiving estradiol and 22% of those receiving placebo.


CONCLUSIONS
In this preliminary study estradiol replacement effectively treats perimenopausal depression independent of its salutary effects on vasomotor symptoms.
Schmidt
P J
PJ
Behavioral Endocrinology Branch, National Institute of Mental Health, Bethesda, MD 20892-1276, USA.
Nieman
L
L
Danaceau
M A
MA
Tobin
M B
MB
Roca
C A
CA
Murphy
J H
JH
Rubinow
D R
DR
D018592:Cross-Over Studies; D003863:Depression / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D005260:Female; D019584:Hot Flashes / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D017697:Premenopause / Q000523:psychology*; D011372:Progestins / Q000627:therapeutic use; D016896:Treatment Outcome
D011372:Progestins; D004958:Estradiol