Estrogen Replacement and Response to Fluoxetine in a Multicenter Geriatric Depression Trial

Schneider, Lon S.; Small, Gary W.; Hamilton, S.H.; Bystritsky, Alexander; Nemeroff, Charles B.; Meyers, Barnett S.

doi:10.1097/00019442-199721520-00002

Cited by 187 publications

(76 citation statements)

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“…Some studies have investigated the possible effect of estrogen as an adjunct treatment for postmenopausal depression. Whereas an early small study failed to show any benefit when CEE was added to the tricyclic antidepressant imipramine in pre-and post-menopausal women with major depression [157], subsequent reports have suggested that the antidepressant effect of SSRIs may be improved by concurrent estrogen treatment [158][159][160][161]. One retrospective non-controlled study did not reproduce this finding.…”

Section: The Use Of Hormonal Therapies In Clinical Practicementioning

confidence: 99%

Hormonal therapy and depression: Are we overlooking an important therapeutic alternative?

Ancelin¹,

Scali²,

Ritchie³

2007

Journal of Psychosomatic Research

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implications: that women vary in vulnerability to mood disorder when abrupt change in steroid levels occur, that these effects could be cumulative across the female lifespan, and that women do not arrive at menopause with equal risk of mood disorders, or equal susceptibility to the effects of hormonal replacement therapy as has been assumed by current clinical research and practice. Conclusion:While hormonal therapies could have positive effects in the treatment and prevention of depressive disorders, further research is required to differentiate hormone-responsive subgroups of women for whom specific hormonal treatments may be most beneficial. To this end we suggest that a multifactorial model of cumulative vulnerability, which takes into account hormonal exposure throughout life, genetic vulnerability and environmental factors, may provide better prediction of treatment response.

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Section: The Use Of Hormonal Therapies In Clinical Practicementioning

confidence: 99%

Hormonal therapy and depression: Are we overlooking an important therapeutic alternative?

Ancelin¹,

Scali²,

Ritchie³

2007

Journal of Psychosomatic Research

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“…Administration of estrogen to PMW for several weeks has also been found to increase cortical serotonin-2A receptors (Kugaya et al, 2003). PMW taking estrogen have improved clinical responses to serotoninergic antidepressants (Nagata et al, 2005;Rasgon et al, 2007;Schneider et al, 1993;Soares et al, 2003b).…”

Section: Introductionmentioning

confidence: 99%

Estrogen Administration Negatively Alters Mood Following Monoaminergic Depletion and Psychosocial Stress in Postmenopausal Women

Newhouse

Dumas

Hancur-Bucci

et al. 2007

Neuropsychopharmacol

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Differences in the rates of affective disorders between women and men may relate to gender differences in gonadal steroid levels such as estrogen that have effects on brain monoamines important to mood regulation. Changes in estrogen secretion patterns during the perimenopause and menopause may be relevant to the increased risk for affective symptoms at that time. This study examined whether 17b-estradiol (E2) administration can modify the mood effects of experimental psychosocial stress following acute monoamine depletion in postmenopausal women. Subjects consisted of 15 normal postmenopausal women (PMW) (ages 67.1711.2 years) blindly placed on either oral placebo or E2 (1 mg/day for 1 month, then 2 mg/day for 2 months). At the end of the 3-month treatment phase, subjects participated in three blinded depletion challenges in which they ingested each of three amino-acid mixtures: deficient in tryptophan, deficient in phenylalanine/tyrosine, or nutritionally balanced. After 5 h, subjects performed the Trier Social Stress Test (TSST), followed by mood and anxiety ratings. E2-treated subjects exhibited a significant increase in negative mood and anxiety after the TSST compared to placebo-treated women. These effects were independent of monoamine depletion and were not manifest before the TSST or at baseline. Exogenous estrogen administration in PMW may alter or modulate emotional reactivity to stressful events and may alter the sensitivity of emotional regulation. This modulation appears to be independent of alterations in monoaminergic neurotransmission. The dose of estrogen used after menopause may be important in determining the effects of gonadal steroids on emotional regulation.

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“…The different formulations of estrogen appear to benefit aspects of CNS function in various animal models (Gibbs, 2000;Wise et al, 2001;Bethea et al, 2002a) and in a few clinical studies (Schneider et al, 1997;Roof and Hall, 2000;Schmidt et al, 2000;Newhouse et al, 2002). However, recent reports have indicated that any formulation of HRT increases peripheral cancer risk (Chlebowski et al, 2003;Kerlikowske et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Effects of Ovarian Steroids and Raloxifene on Proteins that Synthesize, Transport, and Degrade Serotonin in the Raphe Region of Macaques

Smith

Henderson

Abell

et al. 2004

Neuropsychopharmacol

150

127

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In the monkey dorsal raphe, we reported that 1-month (mo) of estrogen replacement, with or without progesterone supplementation for 14 days, significantly increased tryptophan hydroxylase-1 (TPH-1) mRNA; decreased serotonin reuptake transporter (SERT) mRNA and decreased monoamine oxidase (MAO)-A mRNA, but had no effect on MAO-B mRNA. Here, we questioned what effect would 1 or 5 mo of ovarian hormones or the selective estrogen receptor modulator (SERM), raloxifene, have on TPH protein and phosphorylation, and on protein expression of SERT, MAO-A or MAO-B? Raloxifene antagonizes estrogen in breast or uterus, but estrogen-like activities in the brain have been reported. Cytoplasmic and membrane extracts of the dorsal raphe region were processed for Western blotting. TPH, phosphoserine, SERT, MAO-A, and MAO-B were detected with specific antibodies. The optical densities of the signals were measured with NIH image and analyzed by ANOVA. Both 1 and 5 mo of estrogen, with or without progesterone, and 5 mo of raloxifene significantly increased TPH protein. Administration for 5 mo of estrogen plus progesterone and raloxifene also increased TPH phosphorylation. Estrogen, with or without progesterone, for 1 mo had no effect on SERT protein. However, 5 mo of estrogen and 5 mo of raloxifene increased SERT protein. Estrogen alone or combined with progesterone for 1 mo caused a significant reduction in MAO-A. Yet, after 5 mo of the same treatments, MAO-A was not different from spayed controls. Estrogen alone had no effect on MAO-B. However, the addition of progesterone significantly increased MAO-B. Raloxifene for 5 mo had no effect on MAO-A or MAO-B. Thus, to various extents, estrogen, progesterone, and raloxifene may increase serotonin production and transport. The expression of the degradative enzymes suggests a complex combination of gene transcription, post-transcriptional processing, and substrate feedback mechanisms.

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Estrogen Replacement and Response to Fluoxetine in a Multicenter Geriatric Depression Trial

Cited by 187 publications

References 0 publications

Hormonal therapy and depression: Are we overlooking an important therapeutic alternative?

Hormonal therapy and depression: Are we overlooking an important therapeutic alternative?

Estrogen Administration Negatively Alters Mood Following Monoaminergic Depletion and Psychosocial Stress in Postmenopausal Women

Effects of Ovarian Steroids and Raloxifene on Proteins that Synthesize, Transport, and Degrade Serotonin in the Raphe Region of Macaques

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