Cohen Lee S, Soares Claudio N, Poitras Jennifer R, Prouty Jennifer, Alexander Allison B, Shifren Jan L
Perinatal and Reproductive Psychiatry Clinical Research Program and Vicent Memorail Obstetrics and Gynecology Service, Massachusetts General Hospital, Boston, MA 02114, USA.
Am J Psychiatry. 2003 Aug;160(8):1519-22. doi: 10.1176/appi.ajp.160.8.1519.
The authors examined the effect of a 4-week course of estrogen therapy on depression in perimenopausal and postmenopausal women.
Twenty-two depressed women who were either perimenopausal (N=10) or postmenopausal (N=12) received open-label treatment with transdermal 17beta-estradiol (100 micro g/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.
Remission of depression was noted in eight of the 20 women who completed the study; two of these women were postmenopausal, and six were perimenopausal. Antidepressant response was not associated with severity or subtypes of depression at study entry or with concomitant improvement in menopause-related symptoms.
Some perimenopausal women with depression may benefit from short-term use of estrogen therapy, and its role for postmenopausal depressed women warrants further investigation. Antidepressant benefit associated with estrogen therapy may be independent of improvement in physical symptoms.
作者研究了为期4周的雌激素治疗对围绝经期和绝经后女性抑郁症的影响。
22名患有抑郁症的女性，其中围绝经期女性10名，绝经后女性12名，接受了为期4周的经皮17β-雌二醇（100微克/天）开放标签治疗。使用蒙哥马利-阿斯伯格抑郁评定量表和贝克抑郁量表评估抑郁症状，使用格林更年期量表评估与更年期相关的症状，并使用临床总体印象量表（CGI）评估这些女性在基线和治疗后的总体临床改善情况。抑郁缓解定义为在第4周时蒙哥马利-阿斯伯格抑郁评定量表得分<10分且临床总体印象量表得分≤2分。
在完成研究的20名女性中，有8名女性的抑郁症得到缓解；其中2名女性为绝经后女性，6名女性为围绝经期女性。抗抑郁反应与研究开始时抑郁症的严重程度或亚型无关，也与更年期相关症状的同时改善无关。
一些患有抑郁症的围绝经期女性可能从短期雌激素治疗中获益，其对绝经后抑郁症女性的作用值得进一步研究。雌激素治疗带来的抗抑郁益处可能与身体症状的改善无关。
