Fluoxetine efficacy in menopausal women with and without estrogen replacement
Fluoxetine efficacy in menopausal women with and without estrogen replacement
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DOI：
10.1016/s0165-0327(98)00203-1
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发表时间：
1999-09-01
影响因子：
6.6
通讯作者：
Beasley, C
中科院分区：
文献类型：
--
作者：
Amsterdam, J;Garcia-España, F;Beasley, C
40岁以后雌激素水平的逐渐下降可能导致45岁以上女性患抑郁症的几率更高。雌激素替代疗法（ERT）已被证明对女性产生认知和情绪增强作用，并可能促进抗抑郁活性。研究方法：我们检查了接受ERT治疗的≥ 45岁女性患者（n = 40）与未接受ERT治疗的≥ 45岁女性患者（n = 132）、< 45岁女性患者（n = 396）和男性患者（n = 262）在氟西汀每日20 mg治疗8周期间的有效率。然后，在安慰剂对照的复发预防试验中，从第9周至第12周HAM-D-17评分小于或等于7的缓解者接受长达1年的治疗。结果如下：接受ERT治疗的≥ 45岁女性与≥ 45岁女性接受氟西汀单药治疗以及< 45岁女性和男性接受氟西汀治疗的疗效率相似。在氟西汀治疗长达26周的应答者中进行的Kaplan-Meier生存分析显示，与其他治疗组相比，接受ERT治疗的≥ 45岁女性的复发率略高（P < 0.06）。局限性：这项研究是回顾性的，ERT是以一种不受控制的方式给予的：63%的妇女单独接受雌激素治疗，而37%的妇女还间歇性接受孕酮治疗。其他变量包括没有绝经状态的激素记录，没有直接评估ERT依从性和使用固定剂量氟西汀每日20 mg。结论：与先前报告表明ERT可能促进抗抑郁活性相反，我们观察到在年龄≥ 45岁的抑郁女性中，氟西汀联合ERT与氟西汀单药治疗的疗效相似。(C)1999 Elsevier Science B. V.保留所有权利。
A gradual decline in estrogen levels after the age of 40 may contribute to a higher rate of depression in women over 45 years of age. Estrogen replacement therapy (ERT) has been shown to produce cognitive and mood-enhancing effects in women and may facilitate antidepressant activity. Methods: We examined the efficacy rates in women on ERT greater than or equal to 45 years (n = 40) compared to women greater than or equal to 45 years not on ERT (n = 132) and to women < 45 years (n = 396) and to men (n = 262) with major depression during fluoxetine 20 mg daily up to 8 weeks. Remitters with a HAM-D-17 score less than or equal to 7 from week 9 to 12 were then treated up to 1-year in a placebo-controlled, relapse-prevention trial. Results: Efficacy rates were similar in women greater than or equal to 45 years on ERT when compared to women greater than or equal to 45 years taking fluoxetine alone, and when compared to women < 45 years and men taking fluoxetine. A Kaplan-Meier survival analysis in fluoxetine responders treated up to 26 weeks showed a somewhat greater relapse rate in women greater than or equal to 45 years taking ERT compared to other treatment groups (P < 0.06). Limitations: This study was retrospective nature and ERT was given in an uncontrolled fashion: 63% of women received estrogen alone while 37% also took intermittent progesterone. Other variables include the absence of hormonal documentation of menopausal status, no direct assessment of ERT compliance and the use of fixed-dose fluoxetine 20 mg daily. Conclusion: In contrast to prior reports suggesting that ERT may facilitate antidepressant activity, we observed similar efficacy in depressed women greater than or equal to 45 years taking fluoxetine plus ERT compared to those taking fluoxetine alone. (C) 1999 Elsevier Science B.V. All rights reserved.