Menopause: neuroendocrine changes and hormone replacement therapy.
OBJECTIVE
We evaluated the effects of hormone replacement therapy (HRT) alone and in combination with a selective serotonin reuptake inhibitor on mood, cognition, and neuroendocrine parameters in peri- and postmenopausal women.


METHODS
We measured neuroendocrine variations in peri- and postmenopausal depressed patients (DP) and postmenopausal normal control (NC) women (45 to 72 years old) before and after treatment with HRT alone and HRT combined with antidepressant medication. All subjects were without significant medical illness and off psychoactive or other medication that would interfere with neuroendocrine measures.


RESULTS
Menopausal DP women reported greater severity of hot flashes, were less likely to be "morning" types, and had relatively good neuropsychological function compared with NC. DP and NC had comparable levels of reproductive hormones, with the exception of elevated prolactin levels, which increased, as did thyroid-stimulating hormone levels, in response to estradiol treatment. DP had poor sleep quality as measured both by subjective ratings and objective polysomnographic measures compared with NC. In DP estradiol did not enhance the effect of antidepressant alone on mood ratings.


CONCLUSIONS
These findings may differ from other reports in the literature as a function of diagnoses of major depressive episode, randomized controlled trials, or dose and preparation of HRT. Further work is needed on the differential effect of treatment regimens in these disturbances that are evident primarily in baseline neuroendocrine function.
Parry
Barbara L
BL
Department of Psychiatry, University of California, San Diego, USA.
Meliska
Charles J
CJ
Martinez
L Fernando
LF
Basavaraj
Neal
N
Zirpoli
Gina G
GG
Sorenson
Diane
D
Maurer
Eva L
EL
Lopez
Ana
A
Markova
Katerina
K
Gamst
Anthony
A
Wolfson
Tanya
T
Hauger
Richard
R
Kripke
Daniel F
DF
D000339:Affect / Q000187:drug effects; D000368:Aged; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000494:pharmacology; D016022:Case-Control Studies; D003071:Cognition / Q000187:drug effects; D003863:Depression / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy; D006801:Humans; D008019:Life Style; D008593:Menopause / Q000187:drug effects*; D008875:Middle Aged; D009489:Neurosecretion / Q000187:drug effects*; D009490:Neurosecretory Systems / Q000187:drug effects; D017698:Postmenopause / Q000187:drug effects; D011788:Quality of Life; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000494:pharmacology; D011795:Surveys and Questionnaires; D013997:Time Factors
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors