�Women with depression may be practically more probable than work force to make relief from a ordinarily used, cheap antidepressant do drugs, a new national study finds. But many members of both sexes may find that it helps ease their depression symptoms.
The persistence of a grammatical gender difference in response to the dose - even after the researchers accounted for many complicating factors - suggests that there's a genuine biological difference in the way the medication affects women compared with manpower. The reasons for that difference are still ill-defined, but further studies ar now examining hormonal variations that may play a role.
The survey involved citalopram, a commonly used antidepressant that is available both as a generic drug and under the brand name name Celexa.
Researchers from the University of Michigan Depression Center and their colleagues from around the country tested the drug's ability to help depression patients achieve remission, or tot up relief from their symptoms, in a multi-year study called STAR*D.
The gender differences emerged from a detailed analysis of data from 2,876 men and women wHO had a clear diagnosing of major depression, and took citalopram over a number of weeks, with the doses increasing over time.
In the end, women were 33 percent more likely to achieve a full remitment of their depression, contempt the fact that women in the study were more hard depressed than the workforce when the study began.
The study showed no differences between work force and women in side effects, the amount of time that patients stuck to pickings the do drugs, or the amount of time it took for them to achieve remitment of their symptoms.
The new findings, which represent the largest and most stringent analysis ever of grammatical gender differences in response to an antidepressant drug, are published online in the Journal of Psychiatric Research.
Elizabeth Young, M.D., a professor and associate chair of psychological medicine at the U-M Medical School and member of the Depression Center, is the study's lead source. "Other studies have suggested that thither are differences between work force and women in response to different antidepressants, merely the grounds has been conflicting," she says. "This study is large enough, and we were able to control for enough complicating factors, that we feel surefooted there is a true difference. These results have clear implications for the clinical treatment of depression."
Young and her colleagues, including Susan Kornstein, M.D., of Virginia Commonwealth University, and John Rush, M.D., at one time of the University of Texas Southwestern Medical Center at Dallas, conducted the analysis of data from men and women 'tween the ages of 18 and 75, many of whom were being treated by primary care physicians and non psychiatrists. All of the patients had been experiencing depression for years, with the mean length of experience around 12 years.
The study was funded by the National Institute of Mental Health. Unlike many previous industry-sponsored studies of antidepressants, it included a "real world" sample of people with major depression, and did not shut out people world Health Organization had a history of suicidal thought process. The study did non include people with bipolar disorder. Participants in the study could continue with psychotherapy that they had been undergoing before the start of the study, but could take no other antidepressants.
Citalopram is ane of a class of medicines known as SSRIs, or selective serotonin re-uptake inhibitors. In earlier decades, gender differences had been seen in studies of patients pickings an older generation of drugs called tricyclics, with men aid to answer better to such medications. But for more than 15 age, SSRIs feature been the first selection for treating depression.
Although the current study didn't look at hormonal variations between men and women that might account for the difference in response to citalopram, Young and her colleagues note that brute studies have shown that estrogen modifies the brain systems involved in the activity of serotonin, a key nous chemical.
Kornstein is leading further analysis of the STAR*D results to look for possible differences among women according to their menopausal status and their utilisation of hormone replacement therapy. Meanwhile, Young's research as a fellow member of the U-M Molecular & Behavioral Neuroscience Institute focuses on the interactions of sex hormones and stress reaction in depression and other mood disorders.
Overall, women are more unnatural by impression than work force, with about 12 percent of women suffering from some form of depression in a given class compared with 6 per centum of workforce. Depression and other mood disorders are the leading cause of disability among women under the eld of 45.
But the study's authors are quick to caution that their findings don't hateful that citalopram should merely be used in women. Raw data from the study render that 24 percent of men achieved remission with the do drugs, compared with 29 percent of women. The remainder in remission rates grew larger in one case the researchers adjusted for other factors, but the fact remains that many men were helped.
Rather, they note that STAR*D and other studies have shown that many people with depression motive to stress several treatments to find the nonpareil that's right for them and will produce lasting results.
That's wherefore a fresh study called CO-MED has begun. Young and colleagues from U-M and around the country are at present enrolling people with clinical depression for this study that will assess the shock of combinations of medications. One of the medications in that study is escitalopram, a cousin of citalopram, merely it likewise includes former common SSRI antidepressants.
More information on the CO-MED study is available at hTTP://www.depressioncenter.org/research/co-med.naja haje. Information on STAR*D is available at http://www.nimh.nih.gov/health/trials/practical/stard.
In addition to Young, Kornstein and Rush, the study's authors include Sheila Marcus of the U-M Depression Center, Madhukar Trivedi and Diane Warden of UT-Southwestern, Anne Harvey of Via Christi Research, Stephen Wisniewski and G.K. Balasubramani of the University of Pittsburgh and Maurizio Fava of Harvard Medical School.
Reference: Journal of Psychiatric Research, doi:10.1016/j.jpsychires.2008.07.002
Source: Kara Gavin
httUniversity of Michigan Health System
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Saturday, 6 September 2008
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