Estrogen and response to sertraline in postmenopausal women with major depressive disorder: A pilot study

Objective: Pilot study examining the effects of estrogen therapy (ET) on antidepressant response in postmenopausal women with major depressive disorder (MDD). Methods: Twenty-two subjects received sertraline at 50 mg/day for one week, with an increase to 100 mg/day at week 2 for a 10-week trial. Transdermal estrogen or placebo patches 0.1 mg were randomly administered concurrent with the initiation of sertraline treatment. The 21 item Hamilton Depression Rating Scale (HDRS-21) was administered to all patients at baseline and weekly thereafter. Results: Both groups showed a similar significant reduction in HDRS-21 scores by the end of the study. There was no significant difference between the two treatment groups at the end of the 10-week trial, but the women receiving sertraline with ET showed significantly greater early improvement (weeks 2-4) compared to the women receiving sertraline with placebo. Conclusions: Sertraline is an effective antidepressant for postmenopausal women with MDD. ET does not alter the response rate to antidepressant therapy however ET may play a role in accelerating the antidepressant response. (c) 2006 Elsevier Ltd. All rights reserved.