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Sex differences in the psychopharmacological treatment of depression


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It appears we really don't have a good understanding of sex difference in terms of medical treatment and the effect sex hormones have in depression.  Meds are mostly tested on men, men are simpler as there is no baby making. There are of course clear exceptions like Lamictal which is reduced if you are taking HRT or birth control pills. These hormones reduce the level of Lamictal. Men don't have to worry with Lamictal as these kind of hormones are at negligible levels in the male body.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5286730/

 

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Clearer data exists regarding sex differences in antidepressant metabolism, related to absorption, distribution, and elimination. Sex-specific variance has been identified in numerous biological functions influencing pharmacokinetic determinations, including plasma levels, production of gastric acid, gastric emptying times, levels of plasma protein, enzyme activity, and drug transport and clearance rates. However, it is not clear that such differences translate into clinical practice guidelines, as our earlier example of venlafaxine indicates.

A better understanding of the interactions between these many complex systems is probably required to understand sex differences in depression prevalence and treatment response. At the present time, no specific guidelines can be offered, thus the clinician must remain vigilant to the possibility of sex effects either on the levels of exposure achieved with therapeutic dosing or on the clinical efficacy when treating depressed patients. As is true across many types of pharmacotherapy for psychiatric disorders, available guidance provides only a framework for the use of antidepressant pharmacotherapy for the practicing clinician rather than a codified set of instructions applicable to practice.

     

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13 hours ago, notloki said:

It appears we really don't have a good understanding of sex difference in terms of medical treatment and the effect sex hormones have in depression.  Meds are mostly tested on men, men are simpler as there is no baby making. 

Interesting article, definitely food for thought, since women are almost twice as likely as men to get clinical depression......Thanks for posting...

Now I'm wondering about post-menopausal women like me, as compared to a woman of reproductive age.

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On 12/27/2018 at 9:45 AM, CrazyRedhead said:

Interesting article, definitely food for thought, since women are almost twice as likely as men to get clinical depression......Thanks for posting...

Now I'm wondering about post-menopausal women like me, as compared to a woman of reproductive age.

 

The highest risk for depression appears to be the 5 years before and after menopause.

https://www.menopause.org/for-women/menopauseflashes/mental-health-at-menopause/depression-menopause

 

 

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36 minutes ago, notloki said:

The highest risk for depression appears to be the 5 years before and after menopause.

https://www.menopause.org/for-women/menopauseflashes/mental-health-at-menopause/depression-menopause

Interesting......I've been on antidepressants since high school, but the depression got a lot worse right before menopause, and now, 5 years later, still very severe.

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