Estrogen Augmentation of Antidepressants in Perimenopausal Depression: A Pilot Study

Objective: To investigate the effects ofestrogen augmentation on mood and memory inwomen with perimenopausal depression who hadexperienced a partial response to antidepressantmedications.

Method: In a double-blind, placebo-controlledtrial, 17 subjects taking antidepressant medicationwere randomly assigned to either 0.625 mg/day ofconjugated estrogen (N = 11) or matching placebo(N = 6) for 6 weeks. Women between the ages of40 and 60 years with DSM-IV major depressivedisorder (MDD) in partial remission who hadbeen taking antidepressant medication for a minimumof 8 weeks and were experiencing 1 or moreperimenopausal symptoms (hot flashes, nightsweats, irregular periods, sleep disturbance,memory impairment) were recruited from thecommunity. The primary outcome measures werethe final scores for the Hamilton Rating Scale forDepression (HAM-D) and the Buschke SelectiveReminding Test. Data were gathered from April2002 to August 2003.

Results: Women receiving estrogen had asignificantly larger decrease in HAM-D scoresthan women receiving placebo (t = 2.86, df = 15,p = .012). Group differences in tests of verbalmemory were not significant, although improvedscores in verbal memory were significantly correlatedwith a decrease in follicle-stimulating hormone(p = .021).