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Special Issues Related to the Treatment of Depression in Women

Kimberly A. Yonkers, MD

Published: December 1, 2003

Article Abstract

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

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