The evaluation and management of depression in women across the life span

Depression is more common in women than in men, particularly during the chi ldbearing years. Women may present with different depressive symptoms than men and may respond differently to antidepressant treatment. In addition, d epression in women can surface in association with specific points in the r eproductive cycle, such as during the premenstrual period, during pregnancy and the postpartum period, and during the perimenopausal years. Antidepres sant medications may be used effectively at all stages in a woman's life. I n the case of premenstrual dysphoric disorder, serotonergic agents have dem onstrated efficacy in both full-cycle and luteal-phase dosing strategies. F or depressed women who are pregnant or breastfeeding, the limited safety da ta available on antidepressants suggest minimal danger to the fetus or infa nt, and the risks and benefits to both mother and child must be weighed aga inst the risks of untreated illness. Treatment of depression in middle-aged and elderly women should take into account the possible influence of both menopausal status and hormone replacement therapy on antidepressant respons e. This article will focus on special considerations in the evaluation and management of depression in women across the life span.