8/25/00 -- Women who suffer depression as they enter the early stages of menopause (perimenopause) may find estrogen to be an alternative to traditional antidepressants, suggest National Institute of Mental Health (NIMH) researchers. The efficacy of the female hormone was comparable to that usually reported with antidepressants in the first controlled study of its direct effects on mood in perimenopausal women meeting standardized criteria for depression. Drs. Peter Schmidt, David Rubinow of the NIMH Behavioral Endocrinology Branch, and colleagues, report on the findings of this preliminary study in the August 2000 American Journal of Obstetrics and Gynecology.

Estrogen levels, body thermostats and mood often fluctuate in the perimenopause. But only a minority of women become clinically depressed. Although researchers had long suspected that estrogen might lift mood in such women, controlled studies were lacking. Additionally, they hadn't ruled out the possibility that any antidepressant effect could be secondary to the hormone's known ability to reduce hot flushes. The night sweats, experienced by most perimenopausal women, often disturb sleep and may worsen mood, thus confounding assessment of the hormone's antidepressant properties. Might estrogen simply afford a good night's sleep?

To find out, Schmidt and Rubinow studied 34 women, ages 44-55, who experienced onset of depression coinciding with perimenopause, as confirmed by hormone measures and standardized diagnostic interviews. In controlled, randomized fashion, the women received either estrogen or placebo for 3-6 weeks. Using standardized symptom rating scales and structured interviews, the researchers confirmed that estrogen significantly boosted mood in 80 percent of the depressed women, independent of hot flushes. This level of relief, and the time required to achieve a therapeutic effect, about 3 weeks, are comparable to that seen with antidepressant drugs. Only 20% of the women res
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Contact: Jules Asher
jasher@nih.gov
301-443-4536
NIH/National Institute of Mental Health
30-Aug-2000