Transdermal oestrogen for treatment of severe postnatal depression

Grégoire, Alain; Kumar, Ramesh; Everitt, Brian S.; Henderson, A R; Studd, J. W. W.

doi:10.1016/s0140-6736(96)91414-2

Cited by 484 publications

(214 citation statements)

References 29 publications

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“…Negative mood changes in a substantial proportion of women using HRT and oral contraceptives are major problems for compliance to the treatment [4, 5, 50, 51], and in the PMDD symptoms arrive closely to the increase in serum progesterone concentration [1]. In contrast, estrogens have been used in the treatment of depression in women with positive results [9, 10, 11]. Mood disorders related to reproductive hormones can effectively be treated with selective serotonin reuptake inhibitors (SSRI) [8].…”

Section: Discussionmentioning

confidence: 99%

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Serotonin 5-HT<sub>1A</sub> Receptor mRNA Expression in Dorsal Hippocampus and Raphe Nuclei after Gonadal Hormone Manipulation in Female Rats

et al. 2001

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Female ovarian steroids influence mood and cognition, an effect presumably mediated by the serotonergic system. A key receptor in this interplay may be the 5-HT_1A receptor subtype. We gave adult ovariectomized female rats subcutaneous pellets containing different dosages of 17β-estradiol alone or in combination with progesterone, or placebo pellets, for 2 weeks. 5-HT_1A receptor mRNA levels were analyzed by in situ hybridization in the dorsal hippocampus, dorsal and median raphe nuclei, and entorhinal cortex. Estradiol treatment alone reduced 5-HT_1A gene expression in the dentate gyrus and the CA2 region (17 and 19% decrease, respectively). Estradiol combined with progesterone supplementation increased 5-HT_1A gene expression versus placebo in the CA1 and CA2 subregions of the dorsal hippocampus (16 and 30% increase, respectively). Concomitantly, 5-HT_1A mRNA expression was decreased by 13% in the ventrolateral part of the dorsal raphe nuclei, while no changes were found in the median raphe nucleus and entorhinal cortex. Chronic effects of ovarian hormones on 5-HT_1A receptor mRNA expression appear tissue-specific and involve hippocampal subregions and the raphe nuclei. Modulation of 5-HT_1A receptor gene expression may be of importance for gonadal steroid effects on mood and cognition.

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Section: Discussionmentioning

confidence: 99%

“…Interestingly the premenstrual mood change is effectively treated with serotonin reuptake inhibitors [8]. In addition, major depression is more common among females and these patients may respond to estradiol therapy alone [9, 10], or in combination with antidepressant drugs that affect the serotonergic system [11]. …”

Section: Introductionmentioning

confidence: 99%

Serotonin 5-HT<sub>1A</sub> Receptor mRNA Expression in Dorsal Hippocampus and Raphe Nuclei after Gonadal Hormone Manipulation in Female Rats

et al. 2001

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“…Estrogen replacement therapy has been reported to have beneficial effects on postpartum depression [95][96][97], late luteal menstrual depression [85,[98][99][100], and perimenopausal depression [101,102], all conditions characterized by hormonal fluctuation and estrogen withdrawal. Hence, a physiological dose of estrogens was shown to effectively treat premenstrual syndrome, postnatal depression and climacteric depression and has been reported by many investigators whereas only few have concentrated on patients with major depressive disorder.…”

Section: Schizophreniamentioning

confidence: 99%

Drugs with Estrogen-like Potency and Brain Activity Potential Therapeutic Application for the CNS

Cyr¹,

Calon²,

Morissette³

et al. 2000

CPD

102

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Numerous reports, ranging from molecular investigations to clinical studies, demonstrate the potency of estrogens to modulate brain function and their implications in schizophrenia and depression. Alterations of dopaminergic, cholinergic, GABAergic, glutamatergic and serotonergic neurotransmission through estrogen-mediated mechanisms have been consistently established. Moreover, studies using in vivo and in vitro models as well as epidemiological data suggest that estrogens provide neuroprotection of central nervous system (CNS) cells implicated in the etiology of neurodegenerative disorders such as Alzheimer s (AD) and Parkinson s (PD) diseases. Numerous genomic or non-genomic mechanisms of actions of estrogens in the brain have been documented implicating classical nuclear estrogen receptors as well as possible estrogen membrane receptors, antioxidant activity of steroids, their effect on fluidity as well as on antiapoptotic proteins and growth factors. Selective estrogen receptor modulators (SERMs) have estrogenic and/or antiestrogenic activity depending on the target tissue. Hence, SERMs have the same beneficial effect as estrogen in skeleton and cardiovascular systems but act as antagonists in breast and uterus. The finding of beneficial side effects of SERMs in the CNS might improve their risk-benefit ratio in traditional indications. In this review, we will survey schizophrenia and depression as examples of mental diseases and AD and PD as neurodegenerative diseases. We will review brain effects of estrogens, steroids possibly acting as pro-drugs of estrogens such as testosterone and dehydroepiandrosterone (DHEA) and present novel findings with SERMs. Drugs with estrogen activity in the brain may have therapeutic potential either by modulating brain neurotransmitter transmission or through neuroprotective activity.

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“…Gregoire et a1. 13 recently showed that 200 p g of estradiol was more effective than placebo even in patients who had not reacted to psychoactive drugs ( Figure 2). …”

Section: Postnatal Depressionmentioning

confidence: 98%

The psychotherapeutic effects of estrogens

Panay

Studd

1998

Gynecological Endocrinology

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The effect of estrogens on the central nervous system, particularly mood and behavior, remains a controversial area which needs clarification, not just for understanding of depression in women but to ensure that such commonplace problems in women have efficient and appropriate therapy. There is now good evidence that estrogens are rapidly effective in the treatment of depression in many women but this information has not found its way through to those health care personnel, psychiatrists and psychologists who are principally involved in the treatment of depression. There is also strong evidence for the benefits of estrogens on cognitive functioning, not only in preventing the onset of dementia but also in improving the symptoms in the established condition. Recent work has also suggested a benefit for estrogens on mood in women diagnosed as suffering from chronic fatigue syndrome. This article reviews the effect of endogenous estrogen on the female central nervous system and the ever increasing evidence for the diverse psychotherapeutic effects of exogenous estrogens.

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Transdermal oestrogen for treatment of severe postnatal depression

Cited by 484 publications

References 29 publications

Serotonin 5-HT<sub>1A</sub> Receptor mRNA Expression in Dorsal Hippocampus and Raphe Nuclei after Gonadal Hormone Manipulation in Female Rats

Serotonin 5-HT<sub>1A</sub> Receptor mRNA Expression in Dorsal Hippocampus and Raphe Nuclei after Gonadal Hormone Manipulation in Female Rats

Drugs with Estrogen-like Potency and Brain Activity Potential Therapeutic Application for the CNS

The psychotherapeutic effects of estrogens

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