Conditions: Menopause Depression
Keywords: menopause women major depressive disorder Magnetic Resonance Spectroscopy
Allocation: NON_RANDOMIZED | Intervention model: FACTORIAL
Enrollment: 18
Healthy volunteers: yes

Brief summary:
The purpose this study is to measure cortical gama-aminobutyric acid levels (GABA) levels in menopausal women with major depressive disorder and healthy subjects using nuclear magnetic resonance spectroscopy (MRS). Measurements will be compared in 1) menopausal healthy subjects before and after estrogen replacement, and after fourteen days of medroxyprogesterone administration; and 2) in depressed menopausal subjects before and after treatment of their depression with antidepressant alone, estrogen alone or antidepressant plus estrogen. Cortical GABA levels will be correlated with plasma GABA and neurosteroid levels. Neurosteroids to be measured include progesterone, allopregnanolone, pregnenolone, and pregnenolone sulfate.

Detailed description:

Arms:
arm 1: Menopausal women between the ages of 40-70 diagnosed with Major Depressive Disorder receiving treatment with estrogen alone. arm 2: Menopausal women between the ages of 40-70 diagnosed with Major Depressive Disorder receiving treatment with fluoxetine alone. arm 3: Menopausal women between the ages of 40-70 diagnosed with Major Depressive Disorder receiving treatment with estrogen and fluoxetine combined. arm 4: Non-depressed menopausal women between the ages of 40-70 receiving treatment with estrogen alone.

Interventions: intervention 1: MDD diagnosis and Estrogen treatment intervention 2: MDD diagnosis and Fluoxetine treatment intervention 3: MDD diagnosis with both Estrogen and Fluoxetine treatment intervention 4: No depression and estrogen treatment
Intervention descriptions: intervention 1: Treatment for major depressive disorder occurring in the context of the menopause while participating in brain imaging sessions pre and post treatment. Women receiving treatment for depression will be compared to normal controls receiving estrogen only for physical symptoms of menopause. intervention 2: Menopausal women between the ages of 40-70 diagnosed with Major Depressive Disorder receiving treatment with fluoxetine alone. intervention 3: Menopausal women between the ages of 40-70 diagnosed with Major Depressive Disorder receiving treatment with estrogen and fluoxetine combined. intervention 4: Control participants with no MDD diagnosis received estrogen only for the treatment of physical symptoms of menopause.

Protocol document: