Summary
Kornstein SG, Toups M, Rush J, et al. Do menopausal status and use of hormone therapy affect antidepressant treatment response? Findings from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. J Womens Health. 2013;22(2):121-131.
There is little doubt that women are at higher lifetime risk than men to develop depression. Overall, the risk for a major depressive disorder is 1.7 times higher among women than men. Because this difference appears to emerge after puberty and declines during the postmenopausal years, it has been postulated that gonadal hormones might play a role in women’s vulnerability to depression and their therapeutic response to antidepressants.
Kornstein et al utilized data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study to examine whether menopausal status and use of hormonal contraceptives or hormone therapy (HT) would have an impact on treatment efficacy among women receiving the selective serotonin reuptake inhibitor (SSRI) citalopram. Premenopausal (N = 896) and postmenopausal (N = 544) women were treated with citalopram for 12 to 14 weeks and had their treatment response and remission assessed with standardized instruments. There were significant differences between these two groups with respect to demographic and clinical characteristics (eg, postmenopausal women were older, more likely to be divorced or widowed, less educated, and less likely to be employed; postmenopausal women also had overall longer duration of illness and greater likelihood of chronicity than premenopausal women). Notwithstanding, no significant differences in treatment efficacy (response, remission rates) were found when menopausal staging and hormone use (either oral contraceptives or HT) were considered.