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

Abstract 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.