Special Issues Related to the Treatment of Depression in Women

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Depressive disorders in women are commonly associated with reproductive events. This association may be due in part to the changing balance between estrogen, progesterone, and other hormones that affect neurotransmitter function throughout a woman’s lifecycle. Alternatively, they may be related to psychosocial events surrounding these pivotal times or to both sets of conditions. Some data suggest that depression in women tends to respond differently to antidepressant treatment than depression in men, underscoring the need to examine the risk and treatment of depressive disorders in males and females separately. Women have benefited considerably from serotonin reuptake inhibitor antidepressants that are currently available. These agents appear to be more effective than the older tricyclic antidepressants in treating various depressive disorders that occur commonly or exclusively in women. Additionally, serotonin reuptake inhibitors have increased tolerability in women, who generally experience more adverse effects from tricyclics and monoamine oxidase inhibitors than do men. Estrogen appears to enhance antidepressant response in postmenopausal women receiving estrogen replacement therapy. More research is needed, however, that examines how the balance between estrogen, progesterone, and other hormones affects neurotransmitter function.

J Clin Psychiatry 2003;64(suppl 18):8-13