Funny thing. Women are twice as likely to be depressed as men and
get 83 percent of antidepressant prescriptions. Yet current dosing
recommendations are based on studies of men.
Jean Hamilton, M.D., of Duke University, has more than theoretical
grounds for worry. Over a decade ago, while working at the National
Institute of Mental Health, she found that normal variations in the
menstrual cycle affected women's response to widely used psychotropic
drugs, such as lithium. So did oral contraceptives. And when antianxiety
drugs were given to women taking postmenopausal estrogen, they suffered
seizures; what's more, estrogen was less effective against the menopausal
symptoms.
An early benchmark in her research was a manic depressive whose
levels of lithium plummeted before her period, making her "literally
psychotic." Hamilton boosted the dose premenstrually, then returned it to
normal--the two-step dosing worked well.
Hamilton also uncovered some antidepressants and anticonvulsants,
used for certain hard-to-treat depressions, that showed menstrual
variations. "A two-tiered dosing regimen was helpful in more and more
women as we began to look at it," says Hamilton. "It can be the
difference between being hospitalized or being suicidal or not." She has
also explored gender differences in the side effects of neuroleptics,
drugs to combat schizophrenia, and found that women should be receiving
lower doses than men, on whom they were originally tested.
What concerns her most now, though, are over-the-counter diet
pills. Though 90 to 95 percent of users are women--get this--initial
studies proved they were safe in young men. Hamilton sees this as a huge
oversight, since earlier animal studies suggested the pills may give
women high blood pressure, even stroke, especially if they are also using
oral contraceptives.
She thinks there's good reason to study sex difference in
psychoactive drug response.
Tags:
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anticonvulsants,
antidepressant,
depression,
diet pill,
diet pills,
duke university,
gender,
initial studies,
institute of mental health,
lithium,
manic depressive,
menopausal symptoms,
national institute of mental health,
Seizures
