Asma Shaukat, Tariq Mahmud Arain, Amna Shahid, Shahid Irfan, Soufia Farrukh.
Estrogen replacement therapy for depression in perimenopausal women.
J Coll Physicians Surg Pak Jan ;15(10):597-600.

Objective: To determine the effect of a four-week course of oral estrogen therapy on depression in aging women. Design: Quasi experimental. Place and Duration of Study: The OPD, Bahawal Victoria Hospital, Bahawalpur, from September 2000 to January 2004. Patients and Methods: Forty-two depressed women (aged 42-57) who were either perimenopausal (n=20) or postmenopausal (n=22) received open label treatment with oral estrogen tablets(1.25mg/day) for 4 weeks. The Montgomery-Asberg Depression Rating Scale and the Beck Depression Inventory were used to assess depressive symptoms, the Greene Climacteric Scale was used to assess menopause-related symptoms, and the Clinical Global Impression(CGI) was used to assess global clinical improvement in these women at baseline and after treatment. Remission of depression was defined as a score <10 on the Montgomery-Asberg Depression Rating Scale and a score < 2 on the CGI at week 4. Results: The women who completed the study had a median Montgomery-Asberg Depression Rating Scale score of 20 (range= 15-32) at study entry and 11.50 (range= 10-31.0) at week 4 (z = -3.43, p<0.01). This improvement was consistent with that reported by the women themselves on the Beck Depression Inventory (rs=0.86, n=20, p<0.01). The improvement measured by CGI scores was also significant (p<0.01). Remission of depression was noted in 5 of the 40 women (after 1 year) who completed the study. Anti-depressant response was not associated with severity or subtypes of depression at study entry or with concomitant improvement in menopause-related symptoms. Conclusion: Perimenopausal and postmenopausal women benefit from short-term use of estrogen therapy. Antidepressant effect of estrogen therapy is independent of improvement in menopause-related symptoms.

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