Gender matters when treating depression. (Little Comparative Data on Tx Outcomes).

ALBUQUERQUE -- Gender differences in response to antidepressant therapies dearly exist, no question.

The trouble is, there's absolutely no consensus today as to exactly what those gender differences are, according to Dr. Paula Hensley, a psychiatrist at the University of New Mexico.

Only relatively recently has the Food and Drug Administration insisted that drug developers no longer extrapolate from antidepressant studies conducted primarily in men. So the database that will eventually permit definitive comparisons in treatment outcome between men and women isn't all that large yet. And the data that do exist are in marked conflict, she explained at a psychiatric symposium sponsored by the university.

For example, just a couple of years ago, investigators at Virginia Commonwealth University in Richmond published the results of an influential randomized double-blind trial comparing treatment responses to sertraline (Zoloft) versus imipramine in 235 men and 400 women outpatients with chronic depression.

Their conclusion? Women were significantly more likely to respond favorably to sertraline, a specific serotonin reuptake inhibitor, than to imipramine, a tricydlic antidepressant. In men the opposite was true. Women responded to imipramine significantly more slowly than men. And women on imipramine and men on sertraline were more likely to drop out of the study (Am. J. Psychiatry 157[9]:1445-52, 2000).

These gender differences were restricted to premenopausal women. Postmenopausal women had similar response rates to imipraimine and sertraline.

However, these findings were disputed in a new metaanalysis by Dr. Frederic M. Quitkin and his colleagues at the New York State ...