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Pharmacological interventions and hormonal therapies for depressive symptoms in peri- and post-menopausal women: a network meta-analysis of randomized controlled trials

Pharmacological interventions and hormonal therapies for depressive symptoms in peri- and post-menopausal women: a network meta-analysis of randomized controlled trials

Tseng, Ping-Tao, Chiu, Hsien-Jane, Suen, Mein-Woei, Zeng, Bing-Syuan, Wu, Ming-Kung, Tu, Yu-Kang, Hung, Kuo-Chuan, Wu, Yi-Cheng, Su, Kuan-Pin, Li, Dian-Jeng, Chen, Tien-Yu, Stubbs, Brendon, Carvalho, Andre F, Solmi, Marco, Thompson, Trevor ORCID: 0000-0001-9880-782X, Caruso, Maria Gabriella, Matsuoka, Yutaka J., Chen, Yen-Wen, Lin, Pao-Yen, Sun, Cheuk-Kwan, Cheng, Yu-Shian and Shiue, Yow-Ling (2023) Pharmacological interventions and hormonal therapies for depressive symptoms in peri- and post-menopausal women: a network meta-analysis of randomized controlled trials. Psychiatry Research, 326:115316. ISSN 0165-1781 (doi:https://doi.org/10.1016/j.psychres.2023.115316)

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Abstract

Although significant portion of women experience depressive symptoms during or after menopausal transition, there has been considerable controversy over the benefits of hormone replacement therapy (HRT) and antidepressants due to insufficient evidence supporting the superiority of either treatment. This frequentist model based network meta-analysis (NMA) included randomized controlled trials (RCTs) of menopausal depression symptoms management in menopausal women. Seventy RCTs involving a total of 18,530 women (mean age 62.5) were analyzed. The results demonstrated that fluoxetine plus oral HRT [standardized mean difference (SMD)=-1.59, 95% confidence interval (95%CIs)=-2.69 to -0.50] were associated with the largest improvement in depressive symptoms than placebos in overall menopausal women. Similar findings were also noted in the subgroup of participants with a definite diagnosis of depression, while no pharmacological or hormone replacement therapy was better than placebo in the subgroup of post-menopausal women (amenorrhea > 1 year) or in patients without diagnosis of depression. This NMA presented evidence that fluoxetine plus HRT may be beneficial to menopausal women with a definite diagnosis of depression but not to those without depression or post-menopausal women.

Item Type: Article
Uncontrolled Keywords: depression; menopause; intervention; meta-analysis
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RG Gynecology and obstetrics
Faculty / School / Research Centre / Research Group: Faculty of Education, Health & Human Sciences
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development
Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Chronic Illness and Ageing
Faculty of Education, Health & Human Sciences > School of Human Sciences (HUM)
Last Modified: 17 Jul 2023 07:47
URI: http://gala.gre.ac.uk/id/eprint/43045

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