This Month in Psychopharmacology

Highlights From the 2022 NEI Synapse: Depression Throughout the Female Lifespan

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      Austin, TX & Virtual   |   Session Highlights
At the 2022 NEI Synapse, Dr. Mary Kimmel, Assistant Professor, Co-Director of the Perinatal Psychiatry Program, and Medical Director of the NC Maternal Mental Health MATTERS Program at the University of North Carolina School of Medicine, Chapel Hill, NC discussed best practices for diagnosing and treating depression in women throughout their lives in a CME/CE session titled, “Ups and Downs: Diagnosing and Treating Depression Throughout the Female Lifespan."

Women are twice as likely as men to develop depression during their lifetime. Potential contributions to depression in women are the fluctuation of hormones across the lifespan, in addition to a myriad of life stressors that are unique to women (eg. menarche, pregnancy, postpartum, and menopause). In her presentation, Dr. Kimmel discussed the impact of female hormones on mental health, and described how differing estradiol levels during the menstrual cycle influences dorsal and ventral emotion systems and interacts with stressful life events (e.g. trauma). She also addressed best practices for screening for perinatal depression along with prevention interventions, such as the NC Maternal Mental Health MATTERS Program. She presented evidence-based treatments for postpartum depression, such as neuroactive steroids. She wrapped up the presentation with a treatment recommendations consensus for depression in perimenopause/menopause (See Table 1):

Table 1. Treatment Recommendations Consensus for Depression in Perimenopause/Menopause
Treatment Type Stage of Menopause Consensus
Psychotherapies, CBT Any First-line treatments for major depressive episodes
Antidepressants
(SSRIs/SNRIs)
Menopause, especially with vasomotor symptoms (VMS) First-line treatments for major depressive episodes; paroxetine and desvenlafaxine improve VMS
Estrogen Therapy Perimenopause Effective in managing depression symptoms but not depressive disorders
Hormonal contraceptives Approaching menopause When used continuously may improve depressive symptoms
Exercise Peri- and post-menopause Particularly effective when combined with psycho- and pharmacotherapy

Source:  Mary C. Kimmel MD. Ups and Downs: Diagnosing and Treating Depression Throughout the Female Lifespan. Presented April 24 at 2022 NEI Synapse, Austin, TX.

To Learn More: The recording of this presentations by Dr. Mary Kimmel, as well as all of the other presentations from the 2022 NEI Synapse, will be available as Encore Presentations for NEI Members.

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