Gender differences in response to antidepressant treatment prescribed in primary care.: Does menopause make a difference?

Background: Epidemiological surveys have consistently reported that the prevalence of major depression in women is almost twice as high as it is in men. While it seems that no major gender differences have been observed in the severity and symptomatology of depression, results regarding differences in antidepressant treatment response are controversial, especially when considering menopause in treatment response. Methods: A total of 242 women (95 in their menopause), and 59 men beginning antidepressant treatment with a selective serotonin reuptake inhibitor (SSRI; Citalopram, Fluoxetine, Paroxetine or Sertraline) from 16 primary care (PC) centres were followed up during 6 months. Menopause effect and gender differences in antidepressant treatment response were evaluated. Additionally, severity and symptomatology of depression were compared among genders. Results: Overall results suggest that menopause is related to a worse treatment response and to a poorer self-evaluation of global health status. No gender differences were observed in treatment response, depression severity, and symptomatology. Limitations: Since our sample included PC participants, a wide spectrum of depression severity was considered. Additionally, menopause was assessed by means of participants' self-report. Conclusions: Menopause seems to negatively affect SSRI treatment response of depressed women treated in PC. (c) 2006 Elsevier B.V. All rights reserved.