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Am J Psychiatry 160:1519-1522, August 2003
© 2003 American Psychiatric Association


Brief Report

Short-Term Use of Estradiol for Depression in Perimenopausal and Postmenopausal Women: A Preliminary Report

Lee S. Cohen, M.D., Claudio N. Soares, M.D., Ph.D., Jennifer R. Poitras, B.A., Jennifer Prouty, M.S.N., R.N.C., Allison B. Alexander, M.D., and Jan L. Shifren, M.D.

OBJECTIVE: The authors examined the effect of a 4-week course of estrogen therapy on depression in perimenopausal and postmenopausal women. METHOD: Twenty-two depressed women who were either perimenopausal (N=10) or postmenopausal (N=12) received open-label treatment with transdermal 17ß-estradiol (100 µg/day) for 4 weeks. The Montgomery-Åsberg Depression Rating Scale and the Beck Depression Inventory were used to assess depressive symptoms, the Greene Climacteric Scale was used to assess menopause-related symptoms, and the Clinical Global Impression (CGI) was used to assess global clinical improvement in these women at baseline and after treatment. Remission of depression was defined as a score <10 on the Montgomery-Åsberg Depression Rating Scale and a score <=2 on the CGI at week 4. RESULTS: Remission of depression was noted in eight of the 20 women who completed the study; two of these women were postmenopausal, and six were perimenopausal. Antidepressant response was not associated with severity or subtypes of depression at study entry or with concomitant improvement in menopause-related symptoms. CONCLUSIONS: Some perimenopausal women with depression may benefit from short-term use of estrogen therapy, and its role for postmenopausal depressed women warrants further investigation. Antidepressant benefit associated with estrogen therapy may be independent of improvement in physical symptoms.




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