Efficacy of hormone therapy with and without methyltestosterone augmentation of venlafaxine in the treatment of postmenopausal depression: a double-blind controlled pilot study

Dias, Rebecca; Kerr-Corrêa, Florence; Moreno, Ricardo Alberto; Trinca, Luzia A.; Pontes, Anaglória; Halbe, Hans Wolfgang; Gianfaldoni, Arlete; Dalben, Ivete

doi:10.1097/01.gme.0000198491.34371.9c

Cited by 29 publications

(14 citation statements)

References 47 publications

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“…An initial open-label study on estrogen augmentation showed positive results [124], and 1 small placebo-controlled study on perimenopausal women who had partly responded to SSRI treatment found a benefit from adjunctive estrogen [125]. However, another augmentation study found improvement with testosterone, but not with progesterone or estrogen plus progesterone [126]. …”

Section: Resultsmentioning

confidence: 99%

The Integrative Management of Treatment-Resistant Depression: A Comprehensive Review and Perspectives

Carvalho

Berk

Hyphantis

et al. 2014

Psychother Psychosom

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Background: Major depressive disorder is a prevalent and disabling illness. Notwithstanding numerous advances in the pharmacological treatment of depression, approximately 70% of patients do not remit after first-line antidepressant treatment. Methods: The MEDLINE/PubMed, EMBASE and ClinicalTrials.gov electronic databases were searched from inception to October 1, 2013, for randomized controlled trials (RCT), relevant open-label trials, meta-analyses and ongoing trials of pharmacological and psychotherapeutic approaches to treatment-resistant depression (TRD). Results: Switching to a different antidepressant is a useful option following nonresponse to a first-line agent. Although widely used in clinical practice, there is limited evidence to support antidepressant combination for TRD. Notwithstanding evidence for lithium or T₃ augmentation to be successful in TRD, most studies were carried out when participants were treated with tricyclic antidepressants (TCA). Of the available strategies to augment the response to new-generation antidepressants, the use of some atypical antipsychotics is best supported by evidence. Several novel therapeutic options are currently discussed. Evidence suggests that cognitive therapy (CT) is an effective strategy for TRD. Conclusions: The success of switching to a different antidepressant following a first-line agent is supported by evidence, but there is limited evidence for effective combination strategies. Lithium and T₃ augmentation of TCA have the strongest evidence base for successful treatment of TRD. The use of augmentation of newer-generation antidepressants with atypical antipsychotics is supported by a growing evidence base. Current evidence supports CT as an effective strategy for TRD. There is a need for additional large-scale RCT of TRD. The development of new antidepressants targeting novel pathways opens a promising perspective for the management of TRD.

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Section: Resultsmentioning

confidence: 99%

The Integrative Management of Treatment-Resistant Depression: A Comprehensive Review and Perspectives

Carvalho

Berk

Hyphantis

et al. 2014

Psychother Psychosom

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“…A preliminary study of methyltestosterone as augmentation of venlafaxine in the treatment of postmenopausal women with depression showed promising results. 9 However, this study did not investigate the effects of this therapy in women with refractory depression. We hypothesized that low-dose testosterone therapy would be an effective augmentation therapy in women with treatment-resistant depression and conducted an open-label pilot study to investigate this hypothesis.…”

Section: Introductionmentioning

confidence: 95%

Low-dose Transdermal Testosterone Augmentation Therapy Improves Depression Severity in Women

Miller

Perlis²,

Papakostas³

et al. 2009

CNS spectr.

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Background Inadequate response to antidepressant monotherapy in women with major depressive disorder is common. Testosterone administration has been shown to be an effective augmentation therapy in depressed hypogonadal men with selective serotonin reuptake inhibitor-resistant depression. However, the effects of low-dose testosterone as augmentation therapy in women with treatment-resistant depression have not been studied. Methods Low-dose transdermal testoster one (300 mcg/day, Intrinsa, Procter and Gamble Pharmaceuticals) was administered to nine women with treatment-resistant depression in an 8 week open-label pilot protocol. Results There was a statistically significant improvement in mean Montgomery-Asberg Depression Rating Scale (MADRS) scores at 2 weeks, sustained through the 8 week period. Two-thirds of subjects achieved a response to the treatment (decrease in MADRS score of ≥50%) and 33% achieved remission (final MADRS score <10) after 8 weeks of therapy. Mean levels of fatigue, as measured by the MADRS lassitude item, significantly decreased at all time points with a mean 38% decrease from baseline to 8 weeks. Conclusion These preliminary pilot data suggest that low-dose transdermal testosterone may be an effective augmentation therapy in women with treatment-resistant depression. Further studies are warranted.

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“…These antidepressants were selected on the bases of their mechanism of action, FLX as a SSRI, DMI as a NaRI, and VLX as a mixed 5-HT/NA reuptake inhibitor. In addition, VLX has been proposed to have a shorter latency of action and is a useful drug for the treatment of clinical depression in women (Carrol 2006;Dias et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Reduction in the latency of action of antidepressants by 17 β-estradiol in the forced swimming test

et al. 2008

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Efficacy of hormone therapy with and without methyltestosterone augmentation of venlafaxine in the treatment of postmenopausal depression: a double-blind controlled pilot study

Cited by 29 publications

References 47 publications

The Integrative Management of Treatment-Resistant Depression: A Comprehensive Review and Perspectives

The Integrative Management of Treatment-Resistant Depression: A Comprehensive Review and Perspectives

Low-dose Transdermal Testosterone Augmentation Therapy Improves Depression Severity in Women

Reduction in the latency of action of antidepressants by 17 β-estradiol in the forced swimming test

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