Both studies selleck chem Vorinostat indicated that the effect of estradiol on mood was independent of hot flashes – an important finding that suggests that the improvement of depressed mood with estrogen treatment, was not simply a result of improving hot flashes. Both studies identified a rapid onset of antidepressant response in perimenopausal depression. However, the brief duration of the progestin use may be inadequate to determine whether long-term progesterone

use reduces the beneficial estradiol effect on mood.116 Further studies are needed to confirm these positive findings and determine long-term effects of estradiol Inhibitors,research,lifescience,medical treatment. Estrogen administration throughout the cycle may be more effective than the standard OC regimen for decreasing depressive symptoms in perimenopausal women. Blümel et al compared a standard OC (20 μg ethinyl estradiol and 150 mg desogestrel for 21 Inhibitors,research,lifescience,medical days followed by placebo for

7 days) with the same OC followed by only 2 days of placebo and 5 days of 10 μg ethinyl estradiol in a randomized trial.130 Depressive, vasomotor, and somatic symptoms and sexual function improved significantly more in the group with estrogen continued throughout the cycle. The results were interpreted by the researchers to indicate that Inhibitors,research,lifescience,medical increasing the days with estrogen in women using OCs restimulated estrogen receptors and improved cerebral neurochemistry. Antidepressant medications The SSRIs (fluoxetine, paroxetine, and sertraline) and other serotonergic antidepressants such as venlafaxine, nefazodone, and

clomipramine are currently viewed as the first-line this explanation treatment for most depressive disorders because of extensive data supporting their efficacy, the minimal need for dose titration, and generally favorable side-effect profiles.58 Inhibitors,research,lifescience,medical However, there is growing evidence of gender differences and effects of menstrual status in Inhibitors,research,lifescience,medical treatment response and tolerability to SSRIs. Women with chronic major depression were more likely to respond to sertraline compared with men, who were more likely to respond to the tricyclic antidepressant, imipramine.131 Menstrual status affected this response, with premenopausal women significantly Brefeldin_A more likely to respond to the serotonergic than a tricyclic antidepressant, while the postmenopausal women responded similarly to both medications. The postmenopausal women who were taking imipramine also had significantly lower attrition rates than premenopausal women. Similar results were observed in a comparison of fluoxetine with maprotiline.132 Other observations of postmenopausal women identified an interaction between estrogen status and antidepressant therapies: women who were using estrogen replacement therapy and received fluoxetine had a greater antidepressant response than the women who received only fluoxetine133; similarly, older depressed women who received both estrogen and sertraline responded better than those who received only sertraline.