Short-term combinational therapy of low-dose estrogen with selective serotonin re-uptake inhibitor (fluvoxamine) for oophorectomized women with hot flashes and depressive tendencies

Aim: To examine whether low-dose and short-term estrogen-replacement therapy (ERT) plus selective serotonin re-uptake inhibitor (SSRI) treatment is effective or not in the treatment of climacteric disorders, hot flashes and depressive symptoms, in oophorectomized women. Method: Forty-two oophorectomized women with hot flashes and depressive symptoms were assigned randomly to two groups. We examined the efficacy rates of climacteric disorders, particularly hot flashes and depressive symptoms in 21 women on low-dose ERT (conjugated equine estrogens [CEE] 0.3125 mg/day) and 21 women on low-dose ERT (CEE 0.3125 mg/day) plus SSRI (fluvoxamine 50 mg/day) treated for 8 weeks. We used questionnaires to evaluate the efficacy for depression, namely the Self-rating Depression Scale (SDS) and the Self-rating Questionnaire for Depression (SRQ-D), and for anxiety with the State-Trait Anxiety Inventory (STAI). In the statistical analysis, in the mixed-effect model, for the score against time and adjusted with age, treatment and treatment as the fixed effects. Results: The average scores on the SDS in both groups were decreased by the treatment (P < 0.001). But the efficacy of the ERT + SSRI group in the time x treatment SDS and SRQ-D scores was significantly higher compared with those of ERT (P = 0.0025, 0.0162) and there was a significant difference in the decrease in the frequency of hot flashes by 8 weeks between the two groups (P = 0.036). Conclusions: A combination of low-dose and short-term ERT + SSRI is more effective than low-dose estrogen alone in relieving the depressive symptoms and hot flashes of oophorectomized women.