Estrogen replacement therapy for depression in perimenopausal women.
OBJECTIVE
To determine the effect of a four-week course of oral estrogen therapy on depression in aging women.


METHODS
Quasi experimental.


METHODS
The OPD, Bahawal Victoria Hospital, Bahawalpur, from September 2000 to January 2004.


METHODS
Forty-two depressed women (aged 42-57) who were either perimenopausal (n = 20) or postmenopausal (n = 22) received open label treatment with oral estrogen tablets (1.25 mg/day) for 4 weeks. The Montgomery-Asberg Depression Rating Scale and the Beck Depression Inventory were used to assess depressive symptoms, the Greene Climacteric Scale was used to assess menopause-related symptoms, and the Clinical Global Impression(CGI) was used to assess global clinical improvement in these women at baseline and after treatment. Remission of depression was defined as a score < 10 on the Montgomery-Asberg Depression Rating Scale and a score < or = 2 on the CGI at week 4.


RESULTS
The women who completed the study had a median Montgomery-Asberg Depression Rating Scale score of 20 (range = 15-32) at study entry and 11.50 (range = 10-31.0) at week 4 (z = -3.43, p < 0.01). This improvement was consistent with that reported by the women themselves on the Beck Depression Inventory (rs = 0.86, n = 20, p < 0.01). The improvement measured by CGI scores was also significant (p < 0.01). Remission of depression was noted in 5 of the 40 women (after 1 year) who completed the study. Anti-depressant response was not associated with severity or subtypes of depression at study entry or with concomitant improvement in menopause-related symptoms.


CONCLUSIONS
Perimenopausal and postmenopausal women benefit from short-term use of estrogen therapy. Antidepressant effect of estrogen therapy is independent of improvement in menopause-related symptoms.
Shaukat
Asma
A
Department of Pathology, Quaid-i-Azam Medical College, Bahawalpur.
Arain
Tariq Mahmud
TM
Shahid
Amna
A
Irfan
Shahid
S
Farrukh
Soufia
S
D000328:Adult; D003863:Depression / Q000188:drug therapy*; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D047648:Perimenopause; D016896:Treatment Outcome