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The British Journal of Psychiatry (2001) 179: 561
© 2001 The Royal College of Psychiatrists

Correspondence

Gender differences in treatment response to antidepressants

A. H. Young

Department of Psychiatry, The Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, NEI 4LP, UK

EDITED BY MATTHEW HOTOPF

Declaration of interest

I have received speakers' fees from pharmaceutical companies that manufacture SSRIs.

Parker (2001) expertly reviews the evidence for efficacy and effectiveness of different classes of antidepressants. In particular, he addresses the issue of whether selective serotonin reuptake inhibitors (SSRIs) are less efficacious in melancholia; reviews effectiveness studies; examines why there is a discordance between efficacy studies and clinical observation; and reviews the implications of differential effectiveness.

An additional important area that should be considered is that of gender differences in treatment response to antidepressants. Recent evidence has arisen to suggest that women may have a better response to SSRIs and men a better response to tricyclic antidepressants (Kornstein et al, 2000). As depression is approximately twice as common in women than in men, gender differences of this nature are important and should be considered when reviewing this area. The reasons for this difference may be related to the effects of female sex hormones on serotonergic neurotransmission and in particular on the function of the 5-HT1A receptor (Young et al, 1993). The evidence for gender differences in treatment response to antidepressant is not definitive (Kornstein et al, 2001; Quitkin et al, 2001) and further studies are needed to fully establish the validity of this notion. However, there are potentially important implications, and in the future clinical management strategies may take account of gender differences in treatment response.

REFERENCES

  1. Kornstein, S. G., Schatzberg, A. F., Thase, M. E., et al (2000) Gender differences in treatment response to sertraline versus imipramine in chronic depression. American Journal of Psychiatry, 157, 1445-1452.[Abstract/Free Full Text]
  2. Kornstein, S. G., Schatzberg, A. F., Thase, M. E., et al (2001) Dr Korstein and Colleagues reply (letter). American Journal of Psychiatry, 158, 1532-1533.[Free Full Text]
  3. Parker, G. (2001) ‘New’ and ‘old’ antidepressants: all equal in the eyes of the lore? British Journal of Psychiatry, 179, 95-96.[Free Full Text]
  4. Quitkin, F. M., Stewart, J. W. & McGrath, P. J. (2001) Gender differences in treatment response (letter). American Journal of Psychiatry, 158, 1531-1532.[Free Full Text]
  5. Young, A. H., Dow, R. C., Goodwin, G. M., et al (1993) The effects of adrenalectomy and ovariectomy on the behavioural and hypothermic responses of rats to 8-hydroxy-2(di-n-propylamino)tetralin (8-OH-DPAT). Neuropharmacology, 32, 653-657.[Medline]




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