National Alliance on Mental Illness
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Treatment Issues for Women
The treatment of women with depression may be different than treatment for men for several reasons.
Pregnancy
Women with a history of severe depression have a high risk of relapse during pregnancy. The pros and cons of using antidepressants while pregnant, breast-feeding or trying to conceive must be weighed carefully because of the possible risk to the developing fetus or newborn. Large-scale studies have not shown a significant increase in birth defects in women using SSRIs or tricyclic antidepressants while pregnant, but each woman should discuss these issues with her physician.
More information about antidepressants and pregnancy is available from the Mayo Clinic.
Cognitive therapy may be used as an equally effective therapy without the risk of side effects. If a depressed woman has displayed suicidal thoughts or behaviors, treatment discontinuation is not advised.
Breast Cancer
Women taking tamoxifen for the treatment or prevention of breast cancer should be aware of possible interactions with certain antidepressant medications (known as SSRIs).
Many common antidepressants inhibit the efficacy of tamoxifen. Strong inhibitors include paroxetine, fluoxetine, bupropion and duloxetine. Moderate inhibitors include sertraline, citalopram/escitalopram and doxepin. Women should consult with their health care providers to determine the best course of depression treatment for them.
Birth Control Pills
Birth control pills may trigger depression. Sometimes, a new type of pill should be tried before antidepressants. Some types of birth control pills may decrease symptoms of depression among some women, especially those suffering from pre-menstrual disorders.
Thyroid Disease
Women have a higher risk of thyroid disease, which may also cause symptoms of depression. There are two types of thyroid disease. Hyperthyroidism is characterized by nervousness, anxiety and irritability. Hypothyroidism is characterized by fatigue and depression. Women should be tested for thyroid problems before beginning depression treatment if they are experiencing weight gain or loss, sensitivity to temperature, bowel movement changes and period changes.
Side Effects
Women may experience more side effects from antidepressants than men. A lower dosage may lessen this problem.