Article March 1, 1998

Basic Psychopharmacology of Antidepressants, Part 2: Estrogen as an Adjunct to Antidepressant Treatment

Stephen M. Stahl, M.D., Ph.D.

J Clin Psychiatry 1998;59(suppl 4):15-24

Article Abstract

Estrogen exerts profound effects upon behavior by interacting with neuronal estrogen receptors.Changes in estrogen levels over a woman’s life cycle are linked not only to behavioral fluctuations,but potentially to the onset or recurrence of mood disorders. The modern psychiatric evaluation ofwomen requires obtaining a complete reproductive history, including details of hormone treatments,while identifying reproductive events as triggers of affective disorder episodes. While guidelines forthe use of reproductive hormones in psychiatry are just evolving, administration of estrogen as an adjunctto antidepressants is an exciting possibility for expanding the frontiers of psychiatry into thefield of women’s health.