Oestradiol treatment helped a depressed postmenopausal woman to stop her psychotropic medication: a case report

Short-term effects of three continuous hormone replacement therapy regimens on platelet tritiated imipramine binding and mood scores: a prospective randomized trial

OBJECTIVE

To evaluate the effects of continuous hormone replacement therapy (HRT) regimens on platelet-tritiated ((3)H-) imipramine binding (Bmax) and mood.

DESIGN

Prospective randomized study.

SETTING

University hospital.

PATIENT(S)

Sixty postmenopausal patients.

INTERVENTION(S)

Randomization to 3 months of daily treatment with tibolone and conjugated equine estrogen (CEE).625 mg combined either with 2.5 or 5 mg of medroxyprogesterone acetate (MPA). The inclusion criteria-matched patients declined for HRT were prescribed daily alendronate. Pre- and posttreatment blood sampling for Bmax and mood evaluation with the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were done.

MAIN OUTCOME MEASURE(S)

Pre- and posttreatment Bmax and mood scores.

RESULT(S)

As compared with baseline, both CEE+MPA regimens and tibolone significantly increased Bmax. The comparisons of percent change from baseline Bmax for the CEE+MPA and tibolone groups were similar. All three HRT regimens improved the BDI significantly, while there were no significant changes in the STAI. In the alendronate group, there were no significant changes in both pre- and posttreatment Bmax and mood scores.

CONCLUSION(S)

Continuous treatment with CEE+MPA and tibolone increases platelet (3)H-imipramine binding and improves mood. Mood-enhancing effects of tibolone may occur through the serotonergic system, as is the case with estrogen.

Estrogen therapy for depression in postmenopausal women

OBJECTIVE

To look at the modification in depressive mood in postmenopausal depressed women after estrogen replacement therapy (ERT).

METHOD

Twelve depressed patients divided into two groups of six women each were studied. One group received conjugated equine estrogens (CEE) 0.625 mg/day; the other did not receive any treatment (control group). Mood was assessed in all the subjects at baseline and at 6 months with Hamilton Rating Scale score and considered as depression when it was > 15. Differences between groups were determined by Mann-Whitney U-test, and in each group between baseline and 6-month values with Wilcoxon test.

RESULTS

The ERT group had a statistically significant decrease in depressive mood (21 vs. 13 points, P < 0.03), while in the control group no significant change was found. Final Hamilton scale scores were significantly lower (P < 0.05) in those under ERT, when compared with those in the control group.

CONCLUSION

Depressive mood decreased after 6 months with CEE, so the prescription of ERT can be useful in postmenopausal women with depressive mood.