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2012, Número 5

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Salud Mental 2012; 35 (5)


Factores que modifican el efecto antidepresivo de los estrógenos: evidencia preclínica

Estrada-Camarena E

Idioma: Español
Referencias bibliográficas: 69
Paginas: 419-426
Archivo PDF: 119.09 Kb.


RESUMEN

A nivel mundial la prevalencia de los trastornos depresivos ha aumentado, encontrándose un mayor número de casos en individuos del género femenino. En particular se sabe que en la mujer la ocurrencia de episodios depresivos varía a lo largo del ciclo reproductivo, observándose picos en aquellos periodos en los que se presentan cambios hormonales importantes como ocurre durante la perimenopausia, periodo que antecede a la menopausia. De hecho se reporta que en la perimenopausia aumenta la vulnerabilidad para desarrollar trastornos afectivos en mujeres vulnerables.
Una de las alternativas de tratamiento para la depresión asociada a los cambios hormonales que se presentan durante ese periodo es la terapia de reemplazo hormonal con estrógenos (TRE), sin embargo su uso ha dado resultados contradictorios y, hasta el momento, no se ha alcanzado un consenso. Diversos factores podrían explicar las discrepancias encontradas en los trabajos clínicos, entre ellos el tipo de estrógeno, la dosis utilizada, la duración del tratamiento, el estado endocrino de las mujeres incluidas en los estudios y la edad de las mismas.
El presente trabajo revisa evidencia basada en modelos animales en donde se analizan aquellos factores que parecen influir en el efecto antidepresivo de los estrógenos y la compara con la evidencia obtenida en estudios clínicos. Como modelo de menopausia se utiliza a la ovariectomía (OVX) y como modelo para evaluar el potencial antidepresivo de diferentes fármacos se usa el modelo de nado forzado. En este trabajo se revisa el efecto del 17 β-estradiol, el 17 α-etinil- estradiol, el raloxifeno, el tamoxifeno y el dietil-estilbestrol. Además se discute la importancia del tipo de compuesto estrogénico utilizado, la dosis y el tiempo de administración de cada uno de los compuestos, así como la edad y el periodo posterior a la OVX.


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