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Gynäkologische Endokrinologie

, Volume 8, Issue 1, pp 82–88 | Cite as

Depression und Östrogene

Besteht eine kausale Beziehung?
  • M. BirkäuserEmail author
Arzneimitteltherapie

Zusammenfassung

Über Rezeptoren im Zentralnervensystem haben Östrogene modulierende Effekte auf die Stimmungslage sowie auf mentale und kognitive Funktionen. Die Inzidenz von Depressionen ist bei Frauen erheblich höher als bei Männern. Bei Frauen mit besonderer Vulnerabilität kann die menopausale Übergangszeit eine depressive Störung auslösen. Es gibt solide Evidenz aus klinischen Studien dafür, dass eine Östrogengabe während der menopausalen Übergangszeit die Stimmungslage anheben kann, besonders bei Frauen mit vasomotorischen Beschwerden. Für Frauen mit klimakterischen Beschwerden können Östrogene daher als Behandlungsoption bei leichter depressiver Symptomatik angesehen werden. Weiterhin gibt es Daten, die darauf hinweisen, dass Östrogene als adjuvante Therapie die Wirkung von Antidepressiva potenzieren können bei der Behandlung von depressiven Störungen in der Perimenopause und in der frühen Postmenopause sowie – in besonderen Situationen – bei einer schweren Depression in der späten Postmenopause. Keinen positiven Einfluss haben Östrogene auf leichtere Ausprägungen von Depression in der späten Postmenopause. Nicht erwiesen ist, dass Patientinnen mit schweren Depressionen auf Östrogene ansprechen. Ob eine Östrogentherapie kognitive Funktionen verbessern kann, wird noch kontrovers diskutiert.

Schlüsselwörter

Depression Kognition Östrogene Menopause Postmenopause Antidepressiva 

Depression and estrogens

Is there a causal relationship?

Abstract

Through their brain receptors, estrogens modulate mood, mental function, and cognition. The incidence of depression is significantly greater in women than in men. In particularly vulnerable women, the menopausal transition might trigger a depressive disorder. There is suggestive evidence from clinical trials that estrogen therapy improves mood in the menopausal transition, particularly in women suffering from vasomotor symptoms. In women with climacteric symptoms, estrogens might therefore be considered as a treatment for mild depressive symptoms. There are data suggesting that estrogens given as adjuvant therapy potentiate the effect of antidepressants in depressive disorders during the peri- and early postmenopause, and, in special situations, in severe depression in the late postmenopause. Estrogens do not improve even milder forms of depression in the late postmenopause. Estrogens have not been shown to improve severe depression. Estrogen therapy might improve cognition, which is still a controversial issue.

Keywords

Depression Estrogens Cognition Menopause Postmenopause Antidepressants 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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© Springer Medizin Verlag 2010

Authors and Affiliations

  1. 1.Prof. emer. für gynaekologische Endokrinologie und ReproduktionsmedzinUniversitäts-Frauenklinik BernBaselSchweiz

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