Abstract
Three major symptoms of perimenopausal syndrome are vasomotor, psychiatric, and physical symptoms. While hot flashes are most commonly seen, we also often encounter psychiatric symptoms, such as insomnia, anxiety, and depression. We review the combination effect of hormone replacement therapy (HRT) and antidepressants (AD) for the treatment of perimenopausal depression (newly onset depression during the perimenopausal period). We conducted a literature search using PubMed, and found numerous articles about the effect of HRT and AD for treatment of hot flashes. However, we found a very small number of articles about the effect of HRT and AD for perimenopausal depression, and most of them were single arm trials of HRT or AD. We discovered only nine articles of HRT/AD combination therapy. The outcomes were inconsistent, and the effect of HRT/AD combination therapy for perimenopausal depression remains unclear. We discussed the challenges in assessment of severity, process, diagnosis of perimenopausal depression, and dropout due to side effects. Furthermore, we notified the needs of collaboration between gynecologists and psychiatrists. To obtain sufficient reliable data for perimanopausal depression, further investigation will be needed through multidisciplinary cooperation.
