Grigoriadis Sophie, Kennedy Sidney H
Center for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
Am J Ther. 2002 Nov-Dec;9(6):503-9. doi: 10.1097/00045391-200211000-00008.
The role of estrogen in the treatment of depression is reviewed. The relation is examined in studies of perimenopausal and postmenopausal women with depressed mood, in studies of depressive disorders, and in studies of estrogen as an adjunct to antidepressant medication. The literature has many methodologic shortcomings, including combining women of various ages, failure to confirm life stage, the use of different types of estrogens, the inclusion of women with a range of mood disturbances, and the enrollment of women with concurrent psychiatric illness. There are few controlled evaluations of the use of estrogen to supplement ongoing antidepressant treatment. Estrogen alone seems to be beneficial for improving mood in perimenopausal and postmenopausal women. Estrogen is superior to placebo for reproductive-related mood disorders, including postpartum depression and mild depressive disorders during perimenopause. Replication is necessary, especially in moderate to severe levels of major depression. Estrogen may augment antidepressant treatment. Assessment and treatment implications are discussed.
本文综述了雌激素在抑郁症治疗中的作用。研究考察了围绝经期和绝经后情绪低落女性、抑郁症患者以及雌激素作为抗抑郁药物辅助治疗的相关研究。该文献存在许多方法学上的缺陷，包括将不同年龄段的女性合并研究、未确认生活阶段、使用不同类型的雌激素、纳入有多种情绪障碍的女性以及纳入患有并发精神疾病的女性。对于使用雌激素补充正在进行的抗抑郁治疗，几乎没有对照评估。单独使用雌激素似乎对改善围绝经期和绝经后女性的情绪有益。对于与生殖相关的情绪障碍，包括产后抑郁症和围绝经期轻度抑郁症，雌激素优于安慰剂。重复研究是必要的，尤其是在中重度重度抑郁症患者中。雌激素可能增强抗抑郁治疗效果。文中还讨论了评估和治疗的意义。
