Efficacy of estradiol topical patch in the treatment of symptoms of depression following mini-gastric bypass in women

Robert Rutledge, Paul Dorghazi, Cesare Peralgie
Obesity surgery · 2006 · vol. 16(9) , pp. 1221–1226 · doi:10.1381/096089206778392347 · PMID:16989708 · W1974808220
Non-randomised trial OA: closed CC0
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A survey of 711 women following mini-gastric bypass found that topical estradiol effectively treated postoperative depression, with 71% achieving remission and sustained benefit after discontinuation.

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Abstract

BACKGROUND: Obesity is associated with elevated levels of estrogen. Gastric bypass causes rapid weight loss and decreased levels of estrogen. Patients after gastric bypass can suffer from anxiety and depression out of proportion to the surgical outcome. This study reports the efficacy of a short-term empiric trial of topical estradiol for the treatment of mild to moderate depression and anxiety following mini-gastric bypass (MGB) in women. METHODS: Postoperative MGB women were surveyed for the presence of depressive symptoms before and after MGB. The results of an empiric trial of transdermal patches of estradiol-17beta were assessed. Outcome measures were the self-reported efficacy of the patch. RESULTS: 711 women who had undergone MGB and had functioning e-mail addresses made up the study. 62% of patients reported depression prior to surgery. 156 patients (22%) reported depression after the operation. 130 women were treated empirically with the patch, and remission of depression was observed in 92 (71%). In response to the question "Did the estrogen patch help?", subjects reported responses of 1) Yes, fantastic, 2) Yes, somewhat, 3) Hard to say, 4) No, in 36%, 31%, 20%, 13% of respondents respectively. Patients treated with estradiol sustained antidepressant benefit of treatment after the patch was discontinued. Treatment lasted 3 months, in 48%, 32% and 20% respectively. Treatment was well-tolerated and adverse events were rare. CONCLUSION: Depression is common in obese patients and remains a problem in a subset following the MGB operation. Transdermal estradiol replacement appears to be an effective treatment of symptoms of depression in women following MGB.

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MeSH descriptors

Depressive Disorder Depressive Disorder Estradiol Gastric Bypass Obesity, Morbid Obesity, Morbid Administration, Cutaneous Adult Depressive Disorder Drug Administration Schedule Estradiol Estradiol Female Gastric Bypass Humans Middle Aged Obesity, Morbid Patient Satisfaction Treatment Outcome

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