This moderate to large effect size , showing lower ratings of depressed mood in treated patients compared with controls , implicated HRT as a potential treatment of or prophylactic for depression in menopausal women .
One can generalize from the studies review ed here only with great caution , but there is little evidence to support the use of estradiol to improve mood in nondepressed patients ( not surprisingly ) and some evidence to support the antidepressant efficacy of estradiol in perimenopausal but not postmenopausal women
BACKGROUND Controversy regarding the antidepressant efficacy of hormone replacement therapy ( HRT ) stems almost from its inception and reflects the same method ological inconsistencies that have compromised efforts to determine whether the perimenopause is accompanied by an increase in mood symptoms or depression .
Since this publication , multiple studies have aim ed to discern the relationship between HRT and menopausal mood .
METHODS The purpose of this systematic review is to examine the findings and quality of the evidence amassed since Zweifel and O'Brien 's meta- analysis .
Estrogen replacement in perimenopause-related depression: a preliminary report.
OBJECTIVES We examined the efficacy of estrogen in the treatment of depression in perimenopausal women with and without hot flushes . STUDY DESIGN Women with perimenopause-related depression were r and omized in a double-blind parallel design to receive either 17beta-estradiol or placebo for 3 weeks . Subsequently , women receiving estradiol during the first 3 weeks continued receiving estradiol for an additional 3 weeks , whereas women who had received placebo crossed over to estradiol for 3 weeks . Outcome measures included st and ardized mood rating scales and a visual analog scale self-report instrument . RESULTS Of 34 female subjects , 16 received estradiol first and 18 received placebo first . After 3 weeks of estradiol , st and ardized mood rating scale scores and visual analog scale symptom scores ( eg , sadness , anhedonia , and social isolation ) were significantly decreased compared with baseline scores ( P < .01 ) and were significantly lower than scores in women receiving placebo ( P < .01 ) , who showed no significant improvement . Neither the presence of hot flushes nor the duration of treatment ( 3 weeks vs 6 weeks ) influenced outcome . A full or partial therapeutic response was seen in 80 % of subjects receiving estradiol and 22 % of those receiving placebo . CONCLUSION In this preliminary study estradiol replacement effectively treats perimenopausal depression independent of its salutary effects on vasomotor symptoms
This moderate to large effect size , showing lower ratings of depressed mood in treated patients compared with controls , implicated HRT as a potential treatment of or prophylactic for depression in menopausal women .
One can generalize from the studies review ed here only with great caution , but there is little evidence to support the use of estradiol to improve mood in nondepressed patients ( not surprisingly ) and some evidence to support the antidepressant efficacy of estradiol in perimenopausal but not postmenopausal women
BACKGROUND Controversy regarding the antidepressant efficacy of hormone replacement therapy ( HRT ) stems almost from its inception and reflects the same method ological inconsistencies that have compromised efforts to determine whether the perimenopause is accompanied by an increase in mood symptoms or depression .
Since this publication , multiple studies have aim ed to discern the relationship between HRT and menopausal mood .
METHODS The purpose of this systematic review is to examine the findings and quality of the evidence amassed since Zweifel and O'Brien 's meta- analysis .