Magazine article Clinical Psychiatry News

Hot Flashes, Sleep Disruption Contribute to Depression in Menopause

Magazine article Clinical Psychiatry News

Hot Flashes, Sleep Disruption Contribute to Depression in Menopause

Article excerpt

HOT FLASHES AND SLEEP DISRUPTION contribute independently to the development of depression in menopause, judging from the findings of a recent study.

In that study, 29 premenopausal women, aged 18-45 years, received a single dose of the GnRH agonist leuprolide in order to induce hypoestrogenism and ovarian suppression for the study period. The women in the study had no history of primary sleep disturbances, low estrogen levels, or depression, according to Hadine Joffe, MD, director of the Women's Hormone and Aging Research Program at Harvard Medical School, in Boston, and her associates.

All the study participants underwent baseline mood evaluation using both the Montgomery-Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI). Existing sleep disturbances were ruled out at baseline with sleep diaries, questionnaires, and two ambulatory screening polysomnography (PSG) studies.

After 4 weeks of administration of leuprolide, depressive symptoms had developed among most of the women in the study. The mean MADRS score was 4.1, and overall, it was 3.1 points higher than it had been at baseline. One woman had a 15-point increase in her score, suggesting significant depression. The MADRS score increased by at least 5 points in 24% of the women and remained unchanged in 38%, reflecting variability among the women on the impact of leuprolide on depressive symptoms, the investigators reported (J Clin Endocrinol Metab. 2016 Sep 20. doi: 10.1210/jc.2016-2348).

Leuprolide universally suppressed estradiol to postmenopausal levels in the women within 2 weeks. …

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