I was dismayed when I read the commentary by Roger McIntyre and associates1 regarding antidepressants and menopause. The final paragraph, advising practitioners to “familiarize themselves with the beneficial effects of serotonergic antidepressants on climacteric symptoms” is essentially a push to prescribe these medications for symptomatic menopausal women.
This suggestion is backed up by one reference, a position statement of the North American Menopause Society.2 This article is a literature review (I am unaware of any properly conducted clinical studies on this subject) which in fact recommends other interventions (e.g., lifestyle and dietary supplements) as first-line therapy, with SSRIs coming in later, together with progesterone and gabapentin.
Overall, I believe this commentary is misleading. It encourages physicians to prescribe a potent class of medications for climacteric symptoms without the benefit of any careful clinical studies.
Footnotes
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Competing interests: None declared.
We received no response from Dr. McIntyre and colleagues to our invitation to reply to these letters.
References
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