[Comparison of different antidepression therapy in perimenopausal and postmenopausal women with depression]

To study the effects of antidepression drugs and hormone replacement therapy (HRT) in perimenopausal and postmenopausal women with depression.

Eighty six perimenopausal and postmenopausal women with depression were divided into two groups, and treated for 12 weeks, respectively. Forty three received antidepression drugs as control group. Among them, mild to moderate depression were treated with deanxid (1 - 2 pills/d), and severe depression with fluoxetine (20 mg/d). Another 43 took Tibolone (livial) as HRT group (1.25 mg/d). All patients were assessed with the Hamilton depression rating scale for depression (HRSD) and self rating depression scale (SDS) before and at weeks 4, 8, 12 after treatment.

(1) Total effective rate of control and HRT groups was 96% and 93%, respectively, in mild-moderate depression (chi(2)=0.012, P>0.05), while there was a significant difference between two groups in severe depression. The overall effective rates were 93% (control group) and 42% (HRT group), respectively (chi(2) = 5.72, P < 0.01). (2) HRSD of mild-moderate depression was 26.8 +/- 5.7, 10.7 +/- 3.6, 6.4 +/- 3.6, 3.5 +/- 2.5, respectively in control group, and were 25.3 +/- 4.7, 15.2 +/- 5.3, 11.4 +/- 4.4, 4.4 +/- 3.8 in HRT group before and at weeks 4, 8, and 12 after treatment. There was no difference between two groups at weeks 0, and 12 after treatment (P>0.05). HRSD scores of severe depression were 37.6 +/- 5.6, 21.4 +/- 5.2, 14.2 +/- 4.2, 7.3 +/- 2.3, respectively, in control group, and were 38.2 +/- 4.8, 32.6 +/- 5.4, 28.2 +/- 4.6, 24.3 +/- 4.5, respectively, in HRT group before and at weeks 4, 8, and 12 after treatment. There was no difference in HRSD before treatment (P>0.05), but a significant difference at weeks 4, 8, and 12 between two groups (P<0.01). (3) SDS of mild and moderate as well as severe depression was significantly different at weeks 0, 4.8, and 12 in control group (P<0.01), while there was a difference in SDS of severe depression before treatment and at weeks 12 in HRT group (P<0.05). A significant reduction in HRSD and SDS of severe depression was demonstrated in control group than in HRT group (P<0.01)

Antidepression drugs and HRT can improve symptoms of depression in perimenopausal and postmenopausal women, but the effect of antidepression drugs is much better than HRT, especially in severe depression.