What is the role of antidepressant therapy in the treatment of perimenopausal depression?

Updated: Jan 30, 2019
  • Author: Nita V Bhatt, MD, MPH; Chief Editor: Ana Hategan, MD, FRCPC  more...
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For major depression, standard antidepressants are first-line treatments. Selective serotonin reuptake inhibitors (SSRIs) are the antidepressants most commonly used in the treatment of perimenopausal depression. These drugs act by inhibiting serotonin reuptake transporters in the presynaptic neuron, making more serotonin available at the synaptic cleft. The time to onset of action is 4–6 weeks.

SSRIs are thought to be generally safe and effective. They do pose a risk of serotonin syndrome, as well as several common adverse effects (eg, nausea, diarrhea, anorexia, excessive sweating, decreased libido or anorgasmia, headache, jitteriness, dizziness, sedation or activation, insomnia, and akathisia). Several of these medications inhibit the cytochrome P450 (CYP450) enzymes; therefore, it is prudent to check for drug interactions.

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