Gender differences in routine treatment of depressed outpatients with the selective serotonin reuptake inhibitor sertraline

Thiels, Cornelia; Lindén, Michael; Grieger, Frank; Leonard, J. P.

doi:10.1097/00004850-200501000-00001

Cited by 48 publications

(42 citation statements)

References 29 publications

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“…Of the published peer-reviewed studies, five found no difference in the efficacy of SSRIs in men and women (25)(26)(27)(28)(29), and six found SSRIs to be more effective in women (30)(31)(32)(33)(34)(35). There are no reports of SSRIs being more effective in men.…”

Section: Significancementioning

confidence: 99%

Serotonin and arginine–vasopressin mediate sex differences in the regulation of dominance and aggression by the social brain

Terranova

Song

Larkin

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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There are profound sex differences in the incidence of many psychiatric disorders. Although these disorders are frequently linked to social stress and to deficits in social engagement, little is known about sex differences in the neural mechanisms that underlie these phenomena. Phenotypes characterized by dominance, competitive aggression, and active coping strategies appear to be more resilient to psychiatric disorders such as posttraumatic stress disorder (PTSD) compared with those characterized by subordinate status and the lack of aggressiveness. Here, we report that serotonin (5-HT) and arginine-vasopressin (AVP) act in opposite ways in the hypothalamus to regulate dominance and aggression in females and males. Hypothalamic injection of a 5-HT1a agonist stimulated aggression in female hamsters and inhibited aggression in males, whereas injection of AVP inhibited aggression in females and stimulated aggression in males. Striking sex differences were also identified in the neural mechanisms regulating dominance. Acquisition of dominance was associated with activation of 5-HT neurons within the dorsal raphe in females and activation of hypothalamic AVP neurons in males. These data strongly indicate that there are fundamental sex differences in the neural regulation of dominance and aggression. Further, because systemically administered fluoxetine increased aggression in females and substantially reduced aggression in males, there may be substantial gender differences in the clinical efficacy of commonly prescribed 5-HT-active drugs such as selective 5-HT reuptake inhibitors. These data suggest that the treatment of psychiatric disorders such as PTSD may be more effective with the use of 5-HT-targeted drugs in females and AVP-targeted drugs in males.hamster | gender differences | agonistic | social behavior | fluoxetine P rominent sex differences occur in the incidence, development, and clinical course of many psychiatric disorders. Women, for example, have higher rates of depression and anxiety disorders such as posttraumatic stress disorder (PTSD), whereas men more frequently suffer from autism and attention deficit disorders (1-4). Because little is known about sex differences in the efficacy of treatments for these disorders, current treatment strategies are largely the same for both sexes. The development of effective treatments for both women and men can proceed with a clear understanding of sex differences in the mechanisms and etiology of psychiatric disorders. Many of these disorders are linked to deficits in adaptive social skills (5, 6); therefore, understanding the neural mechanisms underlying social engagement in both sexes is essential. In most mammalian species, social interactions among both sexes are governed by dominance relationships. As such, behaviors associated with these relationships (e.g., social recognition, stress, competitive aggression) are the foundation for social interactions and are highly relevant for understanding psychiatric disorders (7-9). Emerging genetic and environmental...

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Section: Significancementioning

confidence: 99%

Serotonin and arginine–vasopressin mediate sex differences in the regulation of dominance and aggression by the social brain

Terranova

Song

Larkin

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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“…Research on selective serotonin reuptake inhibitors (SSRIs) has shown similarly mixed results. Whereas some studies of SSRIs found no gender difference in response (e.g., Thiels et al, 29 Hildebrandt et al 30 ), other studies have reported differences, including a recent large-scale study by Young and et al 31 that reported a better response to the SSRI citalopram by women. Evidence has also suggested gender differences in response to behavioral treatments for depression.…”

Section: Introductionmentioning

confidence: 97%

Inclusion of Women and Gender-Specific Analyses in Randomized Clinical Trials of Treatments for Depression

Weinberger

McKee

Mazure

2010

Journal of Women's Health

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Background: The higher prevalence and cost of depression for women compared with men and the possible gender differences in treatment response demand the inclusion of women in clinical trials of depression treatments. The 1993 National Institutes of Health (NIH) Revitalization Act set a new standard, requiring investigators to consider the inclusion of women and analyze outcomes by gender, yet compliance with these standards in depression research has not been examined systematically. The purpose of this study is to examine the inclusion of women and gender-specific analyses in recent randomized clinical trials (RCTs) for depression. Methods: RCTs were identified through a MEDLINE search for trials published between January 1 and December 31, 2007, and a Clinicaltrials.gov search of self-identified interventional studies to treat depression. Conclusions: Many recent studies of depression treatments include women but do not examine outcomes by gender. Understanding how women differ from men in response to treatment is critical for enhancing treatment efficacy for the greatest number of adults with depression.

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“…For instance, Quitkin et al (2002) found no significant difference in response to the SSRI fluoxetine in a sample of 840 outpatients. In another study, Thiels et al (2005) did not report a significant difference in response to 6-month treatment with the SSRI sertraline. Therefore, the clinical significance of these findings still remains controversial (Quitkin et al, 2002;Hildebrandt et al, 2003;Thiels et al, 2005).…”

Section: Sex Differences In Major Depressionmentioning

confidence: 91%

Neuropharmacogenetics of Major Depression: Has the Time Come to Take both Sexes into Account?

Pitychoutis¹,

Sanoudou²,

Dalla³

et al. 2012

Clinical Applications of Pharmacogenetics

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Gender differences in routine treatment of depressed outpatients with the selective serotonin reuptake inhibitor sertraline

Cited by 48 publications

References 29 publications

Serotonin and arginine–vasopressin mediate sex differences in the regulation of dominance and aggression by the social brain

Serotonin and arginine–vasopressin mediate sex differences in the regulation of dominance and aggression by the social brain

Inclusion of Women and Gender-Specific Analyses in Randomized Clinical Trials of Treatments for Depression

Neuropharmacogenetics of Major Depression: Has the Time Come to Take both Sexes into Account?

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