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Antidepressant Response in Elderly Women on ERT

Does estrogen replacement therapy (ERT) affect antidepressant response in elderly women? This study compared clinical responses of depressed women over age 60 enrolled in a six-week, randomized, placebo-controlled study of fluoxetine (20 mg/day); 72 women were receiving ERT and 295 women were not.

Patients on ERT who received fluoxetine had a significantly greater Ham-D percentage improvement than patients on ERT who received placebo (40% vs. 17%). In contrast, the responses of women not on ERT who received fluoxetine did not significantly differ from those not on ERT who received placebo (36% vs. 30%).

Comment: This study is limited by the short treatment duration and low dose of fluoxetine and because the women were not randomized to ERT treatment and were taking varying ERT compounds and doses for varying durations. In addition, the women had different hysterectomy status and did not provide blood samples for determination of fluoxetine plasma levels. Nonetheless, the results are intriguing and worth pursuing. In the meantime, clinicians might consider estrogen replacement for post-menopausal women with depression who do not respond to antidepressants.

— G Tucker

Published in Journal Watch Psychiatry June 1, 1997

Citation(s):

Schneider LS et al. Estrogen replacement and response to fluoxetine in a multicenter geriatric depression trial. Am J Geriatr Psychiatry 1997 Spring 5 97-106.

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