VCU news

By Joe Kuttenkuler

RICHMOND, Va. – A Virginia Commonwealth University researcher has found that men and women respond differently to two types of anti-depressant medications. Published in the September issue of the American Journal of Psychiatry, the study indicates physicians should consider a patient’s sex when prescribing medication. The report is the first to look at gender-specific differences in how patients with chronic depression respond to treatment.

"When a patient walks into a doctor’s office with depression, most doctors would not make treatment decisions based on whether the patient is a man or a woman," said Susan G. Kornstein, M.D., a psychiatrist at VCU’s Medical College of Virginia Hospitals and lead author of the study. "This study shows us that there are important gender differences to consider, both in evaluating and treating depression."

Researchers at 12 U.S. sites studied 400 women and 235 men during 12 weeks of treatment. The study results showed response rates to the anti-depressant drugs sertraline and imipramine were nearly identical for the study group as a whole, but when researchers analyzed men and women separately, they found dramatic differences.

Results showed women responded better to sertraline while men responded better to imipramine.

"This has tremendous implications for treatment," Kornstein said. "Until recently, medical science has assumed that men and women respond equally well to medications, and we are now learning this is not always true."

As recently as 10 years ago, women were not routinely included in research studies. Kornstein’s interest in women’s health issues led her to investigate the impact gender differences may have on treatment response. "Now that researchers are beginning to look for differences, both men and women stand to benefit."

Sertraline – a selective serotonin reuptake inhibitor or SSRI – sold under the name Zoloft, is one of the most frequently prescribed medications for depression. Imipramine, a tricyclic anti-depressant, was once the gold standard for treating depression, but it is used less often today.

The study also found response differences between pre- and post-menopausal women. Pre-menopausal women responded better to sertraline than to imipramine, while post-menopausal women responded equally well to both drugs. According to Kornstein, this suggests sex hormones may influence women’s response to anti-depressant medications.

Kornstein added that while gender appears to play an important role in the effectiveness of anti-depressant medications, physicians must continue to consider a drug’s potential side effects and overall safety when making treatment decisions.

Depression is twice as common in women as in men and affects nearly 18 million Americans.