Samina Bano, Saima Akhter, Muhammad Iqbal Afridi.
Gender based response to Fluoxetine hydrochloride medication in endogenous depression.
J Coll Physicians Surg Pak Jan ;14(3):161-5.

Objective: To determine the gender based response to fluoxetine HCl medication in relation to tryptophan metabolism in depressed patients. Design: A comparative, analytical study. Place and Duration of Study: Clinical Biochemistry and Psychopharmacology Research Unit, Department of Biochemistry, University of Karachi during the year 2002 to 2003. Subjects and Methods: Sixteen adults depressed patients who were not having any other major comorbidity were selected from the outpatients department of local psychiatric clinic for the study. They were subjected to a semi-structured interview for associated clinical characteristics and diagnosis of depression according to ICD-10 criteria. A control group of normal health male and female individuals was identified for comparison with the depressed group.All the depressed patients were treated with fluoxetine hydrochloride (Prozac 20 mg/day) for four weeks. Healthy individual`s data was compared with the depressed group and evaluated for gender based response to fluoxetine HCl medication. Results: Significant decreases were found in total tryptophan concentrations (33 %, p<0.01,56%, p<0.01) in depressed male and female patients respectively, in contrast, serum cortisol levels were increased by 68% and 98% in male and female depressed patients respectively as compared to healthy controls. Significant increases (23%, p<0.05) in albumin levels were found in females only. Four weeks treatment of male and female depressed group by Fluoxetine HCL (Prozac) 20 mg/kg/day, increased serum total tryptophan concentrations significantly by 32% (p<0.05) in males and by 83% (p<0.01) in females. Serum-free tryptophan concentrations were increased by 22% (p<0.05) in males only. In contrast serum cortisol concentrations were decreased by 31% (p<0.01) and 45.35% (p<0.01) in males and females respectively. Conclusion: Increases in tryptophan and decreases in cortisol concentrations were greater in females which may contribute to better response of the drug in females.

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