�Women with depression may be a great deal more likely than manpower to get relief from a usually used, inexpensive antidepressant dose, a young national study finds. But many members of both sexes may find that it helps ease their depression symptoms.
The persistence of a gender difference in response to the do drugs - level after the researchers accounted for many complicating factors - suggests that there's a real biological difference in the way the medication affects women compared with work force. The reasons for that difference are still unclear, but farther studies are now examining hormonal variations that may play a role.
The study involved citalopram, a ordinarily used antidepressant that is available both as a generic dose and under the brand 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 add together 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 world Health Organization had a clear diagnosis 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 remission of their depression, despite the fact that women in the study were more hard depressed than the hands 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 dose, or the amount of time it took for them to achieve subsidence of their symptoms.
The young findings, which represent the largest and most tight analysis e'er of gender differences in response to an antidepressant, are promulgated online in the Journal of Psychiatric Research.
Elizabeth Young, M.D., a professor and associate professorship of psychiatry at the U-M Medical School and member of the Depression Center, is the study's lead author. "Other studies have suggested that there are differences between hands and women in answer to different antidepressants, only the evidence has been conflicting," she says. "This study is large sufficiency, and we were able to control for enough complicating factors, that we feel convinced there is a unfeigned difference. These results ingest clear implications for the clinical handling 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 between 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 modal 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 domain" sample of people with major natural depression, and did not bar people world Health Organization had a history of suicidal cerebration. The study did not 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 reuptake inhibitors. In earlier decades, gender differences had been seen in studies of patients taking an older generation of drugs called tricyclics, with men attention to respond better to such medications. But for more than 15 years, SSRIs have been the first selection for treating depression.
Although the current study didn't look at hormonal variations between men and women that might accounting for the difference in response to citalopram, Young and her colleagues billet that animate being studies bear shown that estrogen modifies the encephalon systems involved in the activity of serotonin, a key learning ability 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 manipulation of internal secretion replacement therapy. Meanwhile, Young's research as a member of the U-M Molecular & Behavioral Neuroscience Institute focuses on the interactions of gender hormones and stress answer in impression and other mood disorders.
Overall, women ar more touched by imprint than men, with about 12 percentage of women suffering from some form of depression in a given year compared with 6 per centum of work force. Depression and other mode disorders are the starring cause of disability among women under the age of 45.
But the study's authors ar quick to caution that their findings don't mean that citalopram should but be used in women. Raw information from the study bear witness that 24 percent of men achieved remission with the drug, compared with 29 per centum of women. The difference in remitment rates grew larger once 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 want to try on several treatments to find the one that's right for them and will produce lasting results.
That's wherefore a new study called CO-MED has begun. Young and colleagues from U-M and around the country are now enrolling people with slump for this study that will value the impact of combinations of medications. One of the medications in that study is escitalopram, a cousin of citalopram, only it besides includes other common SSRI antidepressants.
More info on the CO-MED study is uncommitted at hypertext transfer protocol://www.depressioncenter.org/research/co-med.asp. 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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