How About Gender Differences In The Response To Treatment Of Depression

How about gender differences in the response to treatment of depression

Psychotherapy
Psychotherapy is an effective treatment for depression. Studies have shown that interpersonal therapy and cognitive/behavioral therapy can be very effective for the treatment of mild to moderate depression. Women and men appear to respond equally well to these to forms of depression-specific psychotherapy. Psychotherapy may be particularly useful for women patients when they are trying to conceive, during pregnancy or while nursing because it allows the woman to avoid possible effects of the medication on the developing fetus or nursing infant.

Antidepressant medications
There is no clear evidence of gender differences in the effectiveness of antidepressant medications; although, women experience more adverse side effects than do men. Selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, Paxil, Luvox and Lexapro have fewer side effects and have been found to be particularly useful and effective in women patients. Some doctors suggest increasing doses of antidepressant drugs premenstrually, as the menstrual cycle may alter drug-absorption rates.

Bright light therapy
Bright light therapy has been used successfully for seasonal affective disorder, but there is as yet no evidence that it is useful for other forms of depression.

Alternative treatments
Other treatments such as acupuncture and nutritional supplements (omega-3-fatty acids) may be helpful in specific circumstances. Women should always talk to their primary care provider or mental health specialist before beginning any treatment for their depressive symptoms. Together, they can choose most appropriate treatment for the specific kind of depression the woman is experiencing.

Is it safe to take antidepressants during pregnancy?

Because of the potential risk to the developing fetus or newborn, the costs and benefits of the use of antidepressants must be weighed carefully for women who are pregnant, breast-feeding, or trying to conceive. Most large-scale studies have not shown any significant increase in birth defects in children of women using either tricyclic antidepressants (Anafranil, Elavil, Pamelor) or SSRIs (Prozac, Zoloft, Paxil, Luvox, Lexapro) during pregnancy. Like all treatments for depression, this is something that each woman should discuss with her physician, weighing the possible risks and benefits of various approaches to treating her depression.

MAOIs (Nardil, Parnate) may adversely affect the developing fetus and lead to complications during delivery. Lithium (commonly prescribed for bipolar disorder) has been linked to an increased incidence of birth defects; however, many healthy babies have been born to mothers using this medication.

Doctors should choose the lowest effective dose of medication and select drugs with the least sedative and anticholinergic (rapid heartbeat, high blood pressure, slow digestion, dry mouth, constipation, and urinary retention) potency because of possible adverse effects on the newborn. In patients with severe depression, doctors must weigh the risks and benefits in both the mother and the infant of medication as compared to not administering drug therapy.

Source: NAMI--The National Alliance on Mental Illness, copyright 2007; www.nami.org; 1-800-950-NAMI