Depression and the menopause: why antidepressants are not enough?


Depression and the menopause: why antidepressants are not enough?
Menopause International 2009; 15: 76–81
The current evidence contributes to a re-reading of the relationship between menopause and mood disorders. Estrogen fluctuations and loss contribute to mild-moderate depression. Estrogens loss modulate some specific characteristics of postmenopausal major depression, such as the insidious onset, the severity of course, the reduced response to conventional antidepressants in comparison to the premenopausal year.
While HT alone can improve mild to moderate mood disorders, the combination of antidepressant with hormone therapy seems to offer the best therapeutic potential for major postmenopausal depression in terms of efficacy, rapidity of improvement and consistency of remission in the follow-up.
Further controlled studies are needed to confirm this role of loss of sexual hormones in the modulation of severity of postmenopausal depression and the potential synergic role of HT with antidepressant to obtain a more satisfactory and persistent therapeutic result.

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