Estrogen, serotonin, and mood disturbance: Where is the therapeutic bridge?
Estrogen, serotonin, and mood disturbance: Where is the therapeutic bridge?
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DOI：
10.1016/s0006-3223(98)00169-3
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发表时间：
1998-11-01
影响因子：
10.6
通讯作者：
Cohen, LS
中科院分区：
文献类型：
--
作者：
Joffe, H;Cohen, LS
越来越多的文献描述了雌激素和其他性腺类固醇对中枢神经系统的影响。特别是雌激素调节雌激素能功能的能力，增加了性类固醇激素可能，在与抑郁症及其治疗相关的机制中发挥作用。这篇综述将集中在雌激素-5-羟色胺相互作用的那些方面，这些方面与可能增加的情感障碍的脆弱性和可能适用于妇女的临床激素治疗有关。在讨论了雌激素和情绪障碍之间的潜在关系，在整个女性的生命周期，提出了一个模型，在该模型中，不同的敏感性情绪障碍解释了不同的反应，一些妇女正常的激素变化的时期。可能的5-羟色胺受体介导的和细胞内的机制，雌激素可能发挥其对情绪的影响也进行了审查。这些是比较标准的抗抑郁作用的推定机制。最后，治疗研究中，雌激素已被用作I）单药治疗抑郁症，2）增强策略，或3）预防性干预对抑郁症的复发进行审查。(C)1998年，生物精神病学学会。
A growing body of literature describes the effects of estrogen and other gonadal steroids on the central nervous system. The ability of estrogen to modulate serotonergic function, in particular, raises the possibility that sex steroids ma?, play a role in the mechanisms associated with depression and its treatment. This review will focus on those aspects of the estrogen-serotonin interaction that relate to possible increased vulnerability to affective disorders and on hormonal treatments that may be clinically applicable to women. After a discussion of the potential relationship between estrogen and mood disorders across the female life cycle, a model is proposed in which differential sensitivity to mood disorders explains the differential response by some women to periods of normal hormonal changes. Possible serotonin receptor-mediated and intracellular mechanisms by which estrogen may exert its effects on mood are also reviewed. These are compared to putative mechanisms of standard antidepressant effect. Lastly, treatment studies in which estrogen has been used as I) monotherapy for depression, 2) an augmentation strategy, or 3) a prophylactic intervention against recurrence of depression are reviewed. (C) 1998 Society, of Biological Psychiatry.