WESTPORT, CT (Reuters Health) - Men and women with chronic depression show different responses to and toleration of selective serotonin reuptake inhibitors and tricyclic antidepressants, report researchers in the September issue of the American Journal of Psychiatry.

"In the past, women were not even included in clinical trials, and in the studies that did include women, the data were usually not analyzed by gender," Dr. Susan G. Kornstein told Reuters Health in an interview. To her knowledge, this is the first published study to examine gender differences in responsiveness to these two classes of antidepressants.

Dr. Kornstein, of the Medical College of Virginia, in Richmond, and multicenter colleagues conducted a double-blind, randomized, parallel-group comparative trial with 235 men and 400 women. The patients, with a diagnosis of major depression or double depression, were randomly assigned to 12 weeks of treatment with either sertraline or imipramine.

The researchers found that women were significantly more likely to respond to sertraline than to imipramine, whereas men were significantly more likely to respond to imipramine than to sertraline.

The dropout rate was also gender- and medication-related; women receiving imipramine and men receiving sertraline were more likely to withdraw from the study. Compared with men, women responded significantly more slowly to imipramine, the authors found.

Differences were also noted in relation to menopausal status, with premenopausal women responding significantly better to sertraline, whereas postmenopausal women had "similar rates of response to the two medications."

The authors recommend that "both gender and menopausal status should be considered in the decision about which antidepressant to use for a depressed patient."

(From Reuters Health)