Antidepressant for perimenopause -
PLoS Med. Yasui, T. Changes in circulating cytokine levels in midlife women with psychological symptoms with selective serotonin reuptake inhibitor and Japanese traditional medicine. Higgins, J. Cochrane Handbook for Systematic Reviews of Interventions version 6.
Cochrane , Available from www. Borenstein, M. A basic introduction to fixed-effect and random-effects models for meta-analysis. Quantifying heterogeneity in a meta-analysis.
Basics of meta-analysis: I2 is not an absolute measure of heterogeneity. In: Higgins JP, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions. Egger, M. Bias in meta-analysis detected by a simple, graphical test. Duval, S. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis.
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Patterns of depressive disorders across 13 years and their determinants among midlife women: SWAN mental health study.
Depressive symptoms across the menopause transition: findings from a large population-based cohort study. Carvalho, A. The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature.
Fava, G. Rational use of antidepressant drugs. Nonhormonal management of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society. Download references. WinShine Clinics in Specialty of Psychiatry, Kaohsiung City, Taiwan. Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.
Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan. Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan. School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK. Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. Department of Emergency Medicine, E-Da Hospital, Kaohsiung, Taiwan. Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan. Department of Chemical Engineering and Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan.
Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan. You can also search for this author in PubMed Google Scholar. and M. W contributed equally as first authors and conceived the study. and P. all contributed to study design and literature review.
and Y. were responsible for data analysis. wrote the draft of the manuscript. and C. both contributed as corresponding authors and took responsibility for revising and submitting the manuscript.
Correspondence to Yu-Shian Cheng or Cheuk-Kwan Sun. The original online version of this Article was revised: The original version of this Article contained errors. Additionally, the study protocol is reported in detail in the Methods section of the Article. Open Access This article is licensed under a Creative Commons Attribution 4.
Reprints and permissions. Wu, CK. Antidepressants during and after Menopausal Transition: A Systematic Review and Meta-Analysis. Sci Rep 10 , Download citation. Received : 23 September Accepted : 19 March Published : 15 May Anyone you share the following link with will be able to read this content:.
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Download PDF. Subjects Health care Medical research Psychiatric disorders. This article has been updated. Abstract To assess the therapeutic benefits of antidepressants in depressive women during and after menopausal transition, PubMed, Cochrane Library, EMBASE and Science Direct were systematically searched from inception to February 1, for randomized controlled trials examining antidepressants compared to placebo.
Introduction Accumulating evidence indicates that women appear to be at a particularly higher risk of the emergence of major depressive disorder MDD and also depressive symptoms not severe enough to meet the diagnostic criteria of MDD during menopausal transition 1.
Methods Guidelines and protocol This systematic review and meta-analysis was conducted according to the guidelines presented in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statement 18 Supplementary Table S1.
Eligibility criteria The inclusion criteria were: 1 peer-reviewed articles investigating the efficacy of antidepressants on depressive symptoms in menopausal women meeting the criteria for MDD or experiencing subthreshold depressive symptoms; and 2 articles that were controlled trials conducted in humans.
Methodological quality appraisal Two independent authors YS Cheng and PT Tseng evaluated the risk of bias inter-rater reliability, 0. Primary outcome The primary outcome measure was a change in the severity of depressive symptoms as rated by standard instruments used in each included study.
Secondary outcomes Secondary outcomes of interest included response and remission rates in each group. Data extraction and management Two independent authors extracted data from the eligible studies into a database of pre-determined variables of interest, including mean age years , mean body mass index BMI , duration of antidepressant treatment weeks , and ethnicity Caucasian, African American, Hispanic, or Asian.
Statistical analysis Based on the presumed high heterogeneity among the included studies, data were analyzed using random-effects meta-analysis models rather than fixed effects models 21 using Comprehensive Meta-Analysis software version 3 Biostat, Englewood, NJ.
Results Study selection The PRISMA flowchart used for study selection in this systematic review is shown in Fig. Figure 1. Flowchart of the Current Systematic Review and Meta-analysis.
Full size image. Table 1 Summary of characteristics of studies in the current meta-analysis. Full size table. Figure 2. Figure 3. Figure 4. Figure 5. Discussion The results of the current meta-analysis were derived from seven RCTs including data from 1, participants, and suggested that antidepressant drug treatment, either with SSRIs or SNRIs, was efficacious for the management of depressive symptoms across the full spectrum of depressive disorders presenting during or after menopausal transition.
Conclusions The current systematic review and meta-analysis provides evidence that antidepressants are effective for the treatment of depressive disorders for women during and after menopausal transition.
Data availability Yu-Shian Cheng Y. References Georgakis, M. Article PubMed Google Scholar Soules, M. Article CAS PubMed Google Scholar Kulkarni, J. Low-dose estradiol and the serotonin-norepinephrine reuptake inhibitor venlafaxine for vasomotor symptoms: a randomized clinical trial.
JAMA Intern Med. Loprinzi CL, Kugler JW, Sloan JA, et al. Venlafaxine in management of hot flashes in survivors of breast cancer: a randomised controlled trial. Pinkerton JV, Kagan R, Portman D, Sathyanarayana R, Sweeney M for the Breeze 3 Investigators.
Phase 3 randomized controlled study of gastroretentive gabapentin for the treatment of moderate-to-severe hot flashes in menopause. Pandya KJ, Morrow GR, Roscoe JA, et al. Gabapentin for hot flashes in women with breast cancer: a randomised double-blind placebo-controlled trial. Butt DA, Lock M, Lewis JE, Ross S, Moineddin R.
Gabapentin for the treatment of menopausal hot flashes: a randomized controlled trial. Loprinzi CL, Qin R, Balcueva EP, et al. Phase III, randomized, double-blind, placebo-controlled evaluation of pregabalin for alleviating hot flashes, N07C1.
Pandya KJ, Raubertas RF, Flynn PJ, et al. Oral clonidine in postmenopausal patients with breast cancer experiencing tamoxifen-induced hot flashes: a University of Rochester Cancer Center Community Clinical Oncology Program study.
Ann Intern Med. Loprinzi CL, Sloan J, Stearns V, et al. Newer antidepressants and gabapentin for hot flashes: an individual patient pooled analysis.
Shams T, Firwana B, Habib F, et al. SSRIs for hot flashes: a systematic review and meta-analysis of randomized trials. J Gen Intern Med. Nelson HD, Vesco KK, Haney E, et al. Nonhormonal therapies for menopausal hot flashes: systematic review and meta-analysis.
Yoon SH, Lee JY, Lee C, Lee H, Kim SN. Gabapentin for the treatment of hot flushes in menopause: a meta-analysis. Sun Z, Hao Y, Zhang M. Efficacy and safety of desvenlafaxine treatment for hot flashes associated with menopause: a meta-analysis of randomized controlled trials.
Perimenopause is a very vulnerable time for women. There is no need for a woman or their families, and colleagues to suffer unnecessarily with these perimenopausal and menopausal symptoms.
If it is continued to be neglected, the mental health, physical health, and general well-being of women and their families alike will continue to suffer. Suicide in middle-aged women is becoming a more common occurrence. It can be prevented with increased awareness of the root causes and the availability of all of the options for treatment.
Beyond hormone replacement therapy to treat menopausal mood changes, anxiety and depression, there is also the option to choose non-hormonal drug therapies which have been shown to reduce some of the more frustrating symptoms of menopause.
There are several classes of antidepressants, but the most often used are serotonin and noradrenaline reuptake inhibitors SNRIs , and selective serotonin reuptake inhibitors SSRIs. They are the most well-investigated group of non-hormonal antidepressants for the treatment of hot flashes.
SSRI antidepressants work by increasing levels of serotonin within the brain. The exact mechanism of how SSRIs and SNRIs decrease menopausal symptoms is unclear, but women taking them often swear by their effectiveness.
Endorphins are chemical messengers that can reduce stress and regulate feelings of happiness, and even euphoria. When there is a reduction in estrogen, there is also a reduction in endorphin production. If endorphin levels are very low, the body temperature increases.
If the endorphins are very high, then there is a decreased body temperature. The result is an overreaction, a hot flash or night sweat, to an internal thermostat that is out of whack. In women with underlying depression, hot flashes, and night sweats taking antidepressants can reduce the number of hot flashes and improve their ability to cope with their overall mood and depression.
Gabapentin and pregabalin can cause dizziness. Clonidine can have some side effects including hypotension, dizziness, and rebound hypertension. Because of the variable adverse effects and efficacy of SSRIs and SNRI drugs, if any one of these drugs is not effective or well-tolerated, another drug can be prescribed.
While women in peri- and menopause may already be suffering from sexual dysfunction symptoms due to reduced hormones, the addition of SSRIs may have some sexual side effects that include diminished sexual desire, trouble achieving and maintaining arousal, and difficulty achieving orgasm. Depression can be both a cause and a result of sexual problems.
Some SSRIs actually increase sexual drive and arousal in women. Ask your doctor about which medication is best for you. SSRIs and other antidepressants can also cause drug interactions that should not be taken lightly.
Always consult a physician before taking prescription medications, changing dosages, or considering stopping. This is a delicate balancing act. Any changes in antidepressant therapy or dosing should be done only in consultation with your healthcare provider.
Be sure to ask your healthcare provider about which SSRI might be best for you. There are several effective types of antidepressants for menopause. The first way to treat depression is with hormone replacement therapy.
When hormones are in balance, neither too high nor too low, women can look and feel their best. But when hormones are not balanced, a range of symptoms can occur including fatigue, trouble sleeping, anxiety, irritability, and depression. This can be just the beginning of a cascade of menopausal symptoms.
Here at Winona , menopausal symptoms can be prevented, treated, and reversed, with a proactive HRT approach that deals with the natural decreases in the hormones estrogen, progesterone, and testosterone. Lifestyle adjustments can also help reduce perimenopause symptoms and promote good postmenopausal health.
Paying attention to healthy eating habits and leading an active lifestyle is important to feelings of wellness and be effective antidepressants for menopause.
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Specific drug-based treatments for symptoms of anxiety and depression during perimenopause are largely unexamined. Instead, researchers are studying existing drugs to gauge their applicability in treating mood changes and reducing anxiety and depression resulting from perimenopause.
Scientists analysing depression during and after perimenopause have found that antidepressants are a potential treatment for moderate to severe symptoms. In , guidelines by the North American Menopause Society, and others, recommended selective serotonin reuptake inhibitors SSRIs and serotonin and noradrenaline reuptake inhibitors SNRIs as front-line medications for depression during perimenopause.
HRT, or systemic estrogen therapy, is also a leading medication to treat perimenopausal symptoms. Research suggests estrogen has antidepressant effects in perimenopausal women, particularly those with concomitant vasomotor symptoms.
Moreover, women with various existing conditions cannot take hormone therapies, and SSRIs and SNRIs may not always be effective. In this backdrop, some companies have taken to studying drugs approved drugs specifically for women undergoing perimenopause.
It remains to be seen if this approach could also work for perimenopause. With an estimated completion date of May , the study strives to utilise the endocrine biology of perimenopause to explain the behavioural and neurobiological features of depression in perimenopausal women.
The National Institute of Mental Health NIMH is exploring the causes of and treatment for perimenopausal depression. For example, NIMH is leading a study to evaluate LY, which was previously being developed by Eli Lilly for treating schizophrenia.
However, seeing a psychiatrist and exploring traditional pharmacotherapy for these conditions is often recommended, which she says is effective. Importantly, studies often do not distinguish between perimenopausal and postmenopausal women, says Raynal.
Unravelling the specific changes of menopause that impact the brain would be most helpful in designing more targeted treatment, Santoro highlights. Give your business an edge with our leading industry insights. Digital Magazine : Pharmaceutical Technology Focus monthly.
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Illustrations contains hand drawn textures. Go deeper with GlobalData. Therefore, antidepressant agents may provide a clinically useful alternative for the management of depressive disorders during menopause.
However, the results of previous studies in this population have been inconsistent, with different findings being reported in the beneficial effects of serotonin-norepinephrine reuptake inhibitors SNRIs 11 and selective serotonin reuptake inhibitors SSRIs As a result, the Endocrine Society in the U.
suggests that antidepressants should only be used for the management of MDD during menopause 7. Furthermore, depressive symptoms of severity less than that of MDD i. Certain guidelines endorsed the use of antidepressants or psychotherapy as frontline treatments for perimenopausal depression Nevertheless, evidence for the therapeutic benefits of antidepressants for menopausal women with subthreshold depressive symptoms is controversial 16 , Therefore, the current study aimed at providing a comprehensive systematic review and meta-analysis of all randomized controlled clinical trials RCTs evaluating the effects of antidepressants in peri- and post-menopausal women with the whole spectrum of depressive disorders during menopausal transition.
In addition, we aimed at: 1 assessing the therapeutic effects of antidepressant treatment in this population; 2 evaluating whether potential benefits of antidepressant agents differ in those with full-blown MDD compared to those experiencing subthreshold depression; and 3 investigating the safety and tolerability of antidepressants.
This systematic review and meta-analysis was conducted according to the guidelines presented in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA statement 18 Supplementary Table S1.
In addition, the ClinicalTrials. gov database was searched using the following search string: [antidepressant] AND [depression and menopause]. This search strategy was augmented through a manual search of the reference lists of eligible articles as well as relevant clinical guidelines and review articles 1 , 4 , 5 , 7 , 8 , 9 , Two authors YS Cheng and PT Tseng screened the titles and abstracts of retrieved references for eligibility.
A list of potentially eligible studies was constructed by consensus, after which full-text examinations were conducted. A third reviewer CK Sun was consulted if any inconsistencies arose.
The inclusion criteria were: 1 peer-reviewed articles investigating the efficacy of antidepressants on depressive symptoms in menopausal women meeting the criteria for MDD or experiencing subthreshold depressive symptoms; and 2 articles that were controlled trials conducted in humans.
No language restrictions were applied. The exclusion criteria were: 1 animal studies; 2 trials not related to the treatment effect of antidepressants on depressive symptoms; and 3 studies without a placebo group i.
Two independent authors YS Cheng and PT Tseng evaluated the risk of bias inter-rater reliability, 0. The primary outcome measure was a change in the severity of depressive symptoms as rated by standard instruments used in each included study.
Secondary outcomes of interest included response and remission rates in each group. We also evaluated the safety of the antidepressants considering dropout rates and the rate of discontinuation due to adverse events.
Two independent authors extracted data from the eligible studies into a database of pre-determined variables of interest, including mean age years , mean body mass index BMI , duration of antidepressant treatment weeks , and ethnicity Caucasian, African American, Hispanic, or Asian.
The corresponding authors were contacted by email to request additional data on at least two different occasions 1 week apart whenever variables of interest were not available. Based on the presumed high heterogeneity among the included studies, data were analyzed using random-effects meta-analysis models rather than fixed effects models 21 using Comprehensive Meta-Analysis software version 3 Biostat, Englewood, NJ.
Heterogeneity was evaluated using the Q statistic 22 , and the I 2 statistic was used to evaluate the proportion of variation We performed the Duval and Tweedie trim and fill test to adjust ESs when evidence of publication bias was found With the automated program of Comprehensive Meta-Analysis software version 3, we arranged sensitivity analysis to verify whether an outlier could be biasing our ES estimates To be specific, to comprehensively evaluate the potential bias contributed to an outlier, we removed one study at a time from the analysis and completed the examination of potential bias contributed by each study included in the current study.
To evaluate potential sources of heterogeneity and confounding effects, we performed meta-regression and subgroup meta-analyses. Specifically, when there were at least ten datasets we conducted the meta-regression procedure using the unrestricted maximum likelihood method.
Regarding subgroup meta-analysis, we focused on the studies that used SSRIs or SNRIs as the antidepressant agents, those that only included participants with a diagnosis of MDD; and trials that excluded participants with MDD [i.
Furthermore, we performed subgroup analysis according to the different depression rating scales that were used in the studies. Subgroup analyses were performed when data from at least three independent studies were provided Statistical significance was set at a two-tailed alpha level of 0.
The PRISMA flowchart used for study selection in this systematic review is shown in Fig. After excluding duplicates, 42 full-text articles were assessed for eligibility. Therefore, seven articles were eligible for the current meta-analysis Table 1 11 , 12 , 16 , 17 , 29 , 30 , All seven studies prohibited the use of any medications or hormone therapies thought to relieve menopausal symptoms or depression in the control groups.
Of the seven studies, three recruited participants with a baseline definite diagnosis of MDD 11 , 12 , 29 , three excluded participants with baseline MDD 16 , 17 , 31 , and the other did not set any limitation regarding baseline MDD i. included participants with the whole depressive spectrum Regarding the antidepressants that were investigated in each RCT, most studies investigated only one antidepressant, including desvenlafaxine in three 11 , 16 , 30 , fluoxetine in one 12 , and paroxetine in one In addition, in the study by Cheng , the authors included two antidepressant-treated groups with different dosages of desvenlafaxine The other two studies investigated two antidepressants at the same time, one with citalopram and fluoxetine 14 and the other one with citalopram and venlafaxine Overall, we found that Unclear reporting of the allocation procedure or attrition bias of the studies further contributed to the risk of bias Supplementary Table S4.
Sensitivity analysis where one study was excluded from analysis at a time revealed that no outlier among the included studies was biasing the overall ES estimates. Forest plot of changes in depressive symptoms in menopausal women with antidepressant treatments compared to those without.
Few moderators could be tested in meta-regression analysis due to the limited number of independent datasets. Forest plots of response and remission rates in menopausal women with antidepressant treatments compared to that in controls.
Funnel plots of meta-analysis on A response rate; B remission rate; C dropout rate, and D adverse event-related discontinuation rate.
Three included studies provided data regarding remission rates 11 , 12 , Six studies including eight antidepressant treatment groups provided data regarding dropout rates 11 , 12 , 16 , 17 , 30 , However, inspection of the funnel plot suggested the presence of publication bias Fig.
Of the seven studies having mentioned the dropout rates, five gave reasons for dropouts Supplementary Table S3. For the treatment group, the reasons were adverse effects in four studies and ineffectiveness in another study.
Forest plots of safety profile of antidepressants reflected by dropout rate and rate of study discontinuation due to adverse events in menopausal women with antidepressants and in those without.
Abbreviations: CI, confidence interval; Dis AE, study discontinuation due to adverse events; MA, meta-analysis; MDD, major depressive disorder; OR: odds ratio. Six studies seven antidepressant-treatment groups provided data on discontinuation due to adverse events 11 , 12 , 16 , 17 , 30 , The inspection of the funnel plot Fig.
The side effects were mostly mild as assessed by the study investigators with the most common being nausea, dry mouth and headache in the antidepressant groups. Detailed information about the adverse events addressed in the included studies is summarized in Supplementary Table S3.
The results of the current meta-analysis were derived from seven RCTs including data from 1, participants, and suggested that antidepressant drug treatment, either with SSRIs or SNRIs, was efficacious for the management of depressive symptoms across the full spectrum of depressive disorders presenting during or after menopausal transition.
Our results also suggested that antidepressant treatment during menopause was associated with higher response and remission rates compared to placebo.
Furthermore, antidepressant treatment was not associated with higher dropout rates compared to placebo, although discontinuation rates due to adverse events were higher among the participants randomized to receive antidepressant compared to placebo.
To the best of our knowledge, the current study is the first to try to synthesize evidence from RCTs on the efficacy, safety and tolerability of antidepressants for the treatment of depressive spectrum disorders during and after menopausal transition. The present study had its strengths and limitations.
Due the availability and inclusion of seven unique RCTs, we were able to perform a meta-analysis and investigate factors that may influence the therapeutic effects of antidepressants among peri- and post-menopausal women.
Our results suggested that antidepressants could be efficacious for women who developed MDD during or after menopausal transition as well as for those presenting with subthreshold depressive symptoms. This is particularly relevant because cross-sectional and prospective studies have indicated that depressive symptoms in this population appear to occur on a continuum of severity 14 , 32 , Moreover, subthreshold depression may significantly impair the quality of life and functioning of this population 14 , which may also increase the risk of MDD in a subset of women during or after menopausal transition 32 , Furthermore, most of the studies seemed to have fair quality, while there was only dominant unclear risk in the item of allocation concealment.
However, most of the studies were conducted in North America, with only one from the Middle East 29 and one from North Europe Therefore, extrapolation of the results to other populations may not be justified. In addition, treatment with antidepressants was associated with a higher likelihood of achieving response and remission relative to a placebo.
However, there was evidence of publication bias on the overall effects of antidepressants on treatment response, and hence the results should be interpreted with caution since this effect was rendered non-significant following adjustments for publication bias.
It is also worth noting that only three trials provided data regarding response and remission rates. Moreover, as in most meta-analyses, another limitation of the current study was the heterogeneity of the included studies in terms of study duration, drug dosage, the use of different depression scales and different versions e.
Therefore, we performed subgroup analysis and meta-regression to investigate how different factors may affect the study results. Meta-regression showed that certain factors such as duration and age did not affect our results, and our subgroup analysis demonstrated that antidepressant treatment was still effective for those suffering from subthreshold depression.
Nevertheless, the number of studies was too small to allow other meaningful subgrouping or meta-regression analyses. Besides, there was heterogeneity in some estimates, the sources of which were explored through subgroup and meta-regression analyses.
However, due to the relatively small number of studies, the results from these analyses should be regarded as exploratory instead of conclusive.
Furthermore, in recent years, perimenopausal depression is considered a distinct subtype of depression that warrants a unique rating scale for evaluation 3. Nevertheless, most studies in the present meta-analysis were old and did not use criteria specified for perimenopausal depression 3.
The issue was further complicated by the fact that most studies included a mixed population of women during menopausal transition and in the postmenopausal phase. Therefore, whether the instruments reported in those studies could capture the complex symptoms of perimenopausal depression remains to be elucidated.
Finally, the overall body of evidence remains limited in this area. Because the treatment of depression during menopause remains a clinical challenge, the findings of the present study had its clinical implications.
The current meta-analysis indicates that antidepressants could be efficacious for the treatment of this condition in this vulnerability period of the female reproductive cycle.
However, only three RCTs included participants with a definite diagnosis of MDD 11 , 12 , An evidence-based psychotherapeutic approach for depression e. Interestingly, we did not identify any RCTs on the effects of tricyclic antidepressant agents in postmenopausal women with depression.
Therefore, this meta-analysis provides evidence for the use of SSRIs and SNRIs as treatments for depression in this population. Specifically, the antidepressants fluoxetine 12 , 17 , citalopram 17 , 29 , paroxetine 31 , desvenlafaxine 11 , 16 , 30 and venlafaxine 29 were tested across the included RCTs.
Further research is warranted to investigate the effects of other antidepressants in this population. There was no significant difference in dropout rate between the participants treated with antidepressants and those who received a placebo.
However, antidepressant treatment was associated with a greater likelihood of discontinuation due to adverse events. This is consistent with an increasing number of studies that have raised concerns regarding the safety and tolerability of newer generation antidepressants, including SSRIs and SNRIs Such concerns should be weighed when considering the use of antidepressants, especially for women during or after menopausal transition with less severe forms of depression The current systematic review and meta-analysis may provide new directions for research.
First, only acute antidepressant trials were identified. However, depressive disorders in postmenopausal women appear to have heterogenous symptom trajectories 32 , 33 , and further investigations are warranted to investigate the benefits of maintenance treatment with antidepressants for depressive disorders in this population i.
In addition, our subgroup analysis suggested that SNRIs but not SSRIs were associated with higher discontinuation rates due to adverse events relative to a placebo.
However, further RCTs are needed to confirm this finding. It has been suggested that the presence of vasomotor symptoms during menopause may contribute to the development and persistence of depressive disorders during this phase of the female reproductive cycle 14 , and also that low-dose paroxetine and SNRIs could improve these symptoms Therefore, further research is needed to investigate whether the amelioration of vasomotor disturbances could contribute to the beneficial effects of antidepressants seen in the current study.
Finally, the evidence base regarding options for the treatment of depressive disorders during menopause remains limited. The design of new RCTs is a necessary step before firm conclusions regarding the comparative efficacy and tolerability of various pharmacological treatments can be made.
The current systematic review and meta-analysis provides evidence that antidepressants are effective for the treatment of depressive disorders for women during and after menopausal transition.
Long-term RCTs are required to investigate the efficacy, safety, and tolerability of maintenance treatment with antidepressants during menopause. Yu-Shian Cheng Y. and Ping-Tao Tseng Y. both had full access to all the data in this study, conducted the data analysis, and took responsibility for integrity of the data and accuracy of the data analysis.
The data of the current study are available within the article and its supplementary materials. For further information, requests shall be directed to the corresponding author. Georgakis, M. et al. Association of age at menopause and duration of reproductive period with depression after menopause: A systematic review and meta-analysis.
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Antidepressants forr Antidepressant for perimenopause that help treat symptoms of depression. Perimenopausee impact Flavonoids and mood enhancement type of chemical called a neurotransmitter. Neurotransmitters carry messages between the cells in your brain. Despite their name, antidepressants can treat a variety of conditions besides depression. These include:.
Perimenopause is perimenkpause process — foe gradual transition. No one test or sign is Antidepressatn to determine Antidepressant for perimenopause you've Natural energy supplement perimenopause. Antidepessant doctor takes many things into consideration, including your age, menstrual history, and what symptoms or body changes you're experiencing. Some doctors may order tests to check your hormone levels. But other than checking thyroid function, which can affect hormone levels, hormone testing is rarely necessary or useful to evaluate perimenopause.
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