Escitalopram for perimenopausal depression: an open-label pilot study.
BACKGROUND
Women have a relatively high risk of experiencing depressive episodes during the perimenopause. Indications for and acceptance of hormone replacement therapy (HRT) are increasingly controversial, and serotonin reuptake inhibitor antidepressants are an attractive potential treatment option for both the mood and somatic symptoms of perimenopause.


METHODS
This study is an open-label, 8-week trial of escitalopram for perimenopausal depression and somatic symptoms associated with perimenopause. Twenty women received escitalopram and were serially assessed with the Hamilton Rating Scale for Depression (HAMD, 30-item), the Greene Climacteric Scale (GCS), and the Clinical Global Impression (CGI).


RESULTS
There were significant differences between pretest and posttest scores for each measure, as demonstrated in an intent-to-treat analysis: GCS (p < 0.0001), HAM-D30 (p < 0.0001), and CGI (p < 0.0001). Two subjects dropped out prior to the second visit because of drug side effects. In this study, benefits of treatment were observed in several domains of perimenopausal symptoms, including those representative of psychological, vasomotor, and somatic symptoms. The limitations of this study are small sample size and lack of placebo control.


CONCLUSIONS
Larger, long-term, controlled trials of antidepressants are warranted for the treatment of perimenopausal depression and associated somatic symptoms.
Freeman
Marlene P
MP
Women's Mental Health Program, Departments of Psychiatry, University of Arizona College of Medicine, Tucson, Arizona 85724-5002, USA. marlenef@email.arizona.edu
Hill
Rebecca
R
Brumbach
Barbara H
BH
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage*; D015283:Citalopram / Q000008:administration & dosage*; D003863:Depression / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D047648:Perimenopause / Q000523:psychology*; D010865:Pilot Projects; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016387:Women's Health
D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram