The Change Of Sexual Hormone In Depressive Patients Before And After Treatment And Its Relationship With Their Efficacy

Objective: To compare the difference of sex hormones'changes between depressive patients and normal control groups ; to explore the influence of sex hormone in different age patients groups; to analyze the change of sexual hormone in depressive patients before and after different treatment and its relationship with their efficacy.Methods: 80 patients of depression disorder (40 males and 40 females), 60 normal controls. Their serum progesterone, estradiol , prolactin, follicle stimulating hormone, luteinizing hormone and testosterone levels were measured by chemiluminescence instrument at the baseline in 80 depressive patients and at the end of 8 weeks after treatment, compared with 60 normal controls. Based on the age stages, the depressive patients were divided into three groups. Females: group 1, age 18-29; group 2, age 30-41; group 3, age 42-53. Males: group 1, age 18-34; group 2, age 35-50; group 3, age 51-65. 80 inpatients with a diagnosis of depression were randomly assigned to velanfaxine or paroxetine groups for 8 weeks treatments. Efficacy and safety were assessed by HAMD (Hamilton Rating Scale for depression), CGI (Clinical Impression rating scale) and TESS (Treatment Emergent Symptoms Scale). Assessments were performed at baseline and weeks 1,2,4 and 8. To compare the difference of sex hormones'changes between depressive patients and normal controls ; to explore the influence of sex hormone in different age range patients groups; to analyze the change of sexual hormone in depressive patients before and after different antidepressants treatment and the relationship with their efficacy.Results: The estradiol levels of female patients with depressive desorder before treatment were significant lower than that of the normal controls. The luteinizing hormone and testosterone levels before treatment were significant higher than that of the normal controls. The progesterone, prolactin and follicle stimulating hormone levels were not different between women patients and the controls. After treatment, the luteinizing hormone and testosterone levels were still higher than that of the normal controls. There were not significantly different in the estradiol,prolactin and follicle stimulating hormone levels between patients in women and normal controls after treatment. The testosterone levels of male patients with depression were significantly lower than that of the controls. After treatment, the testosterone levels of male patients increased significantly, but were still lower than that of the controls. And prolactin levels were also increased. The estradiol levels were significant differently before and after treatment in male patients. Divided into three different age-stage groups, all of the estradiol levels were increased after treatment in female patients. In the group 2 and 3, the testosterone levels of female patients were significantly lower than that of pre-treatment. The testosterone and estradiol levels were significantly increaded after treatment in different age-stage groups of male patients. In elderly male patients group, the progesterone and prolactin levels were also significantly increased after treatment. Compared with female patients, male patients (especially in the elderly men) have more complex changes in the sexual hormone levels. After the treatment with velanfaxine or paroxetine, the estradiol levels were significantly increased in female patients, and the testosterone levels were significantly decreased. The estradiol, testosterone and progesterone levels were significantly increased in the velanfaxine group of male patients. Before treatment, the estradiol and testosterone levels were significantly lower in remission group than that of the not-remission group in male patients, and the remission group's estradiol levels were significantly higher than that of the not-remission group. After treatment, the follicle stimulating hormone and luteinizing hormone in not-remission group of male patients were significantly higher than that of the remission group. The estradiol levels were significantly increased in the remission-gruop of female patients. Both of the HAMD scores of male depressive patients before and after treatment had positive correlation with estradiol levels. Both of the HAMD scores of female depression patients before and after treatment had negative correlation with estradiol levels. It is suggested that the influence of the different antidepressant drug would be various to the sexual hormone levels of the humen beings. The change of the estradiol levels may become a standard of forecasting the anti-depressive early outcome.Conclusions: (1)The serum estradiol levels in women with depression were decreased, and the testosterone levels were significantly increased. The serum testosterone levels in men with depression were significantly decreased. After treatment, the serum estradiol levels in women with depression were significantly increased, and reached the level of the normal controls. But the serum testosterone levels in men with depression were still lower than that of the controls after treatment. (2) Divided into three different age-stage groups, all of the estradiol levels were increased after treatment in female patients. In the age-stage of 30-53 years, the testosterone levels of female patients were significantly decreased. The testosterone and estradiol levels were significantly increaded after treatment in different age-stage groups of male patients. There was a complex changes in the sexual hormone of the elderly male patients. (3) Antidepressant drugs had a little significant effect on the sexual hormone levels in depressive patients, but couldn't make it recovered. The sexual hormone levels changed obviously in the remission groups. The HAMD scores of male depression patients had positive correlation with the estradiol levels. The HAMD scores of female depression patients had negative correlation with the estradiol levels. The change of the estradiol levels may become a standard of forecasting the anti-depressive early outcome.