Farmacoterapia de los trastornos depresivos unipolares en la mujer / Pharmacotherapy for Unipolar Depression in Women

ABSTRACT

Epidemiologic and clinical studies have shown gender differences between men and women in unipolar depression, mainly related with hormonal variables that would determine women's specific organization and/or activation of the central nervous system from intrauterine to postmenopausal life. It is recognized that there are a higher prevalence of unipolar depression among women, a predominance of atypical depressive symptoms, a better response to MAOI and SSRI between menarche and menopause, and a higher frequency of rapid cycling and seasonal pattern. Depression during pregnancy and the postpartum, as well as the higher prevalence of thyroid diseases and stronger reactivity to stress of the axis that regulates the secretion of CRF, ACTH and cortisol, support the hipotheses of hormonal etiologies in these pictures and give an explanatory base to the observed differences. The appropriate distinction between unipolar and bipolar depression, the correct election of an antidepressive treatment and the exploration of the efficacy and efectiveness of other therapeutic strategies, such as light-therapy, sleep deprivation and thyroid and /or gonadal steroids supplementation or replacement therapy, are factors that must be taken into account when treating a depressive woman.