Association between changes in estradiol, serotonin, and BDNF and antidepressant response in perimenopausal depression: a retrospective cohort study comparing integrated TCM-acupuncture with SSRIs.
Integrated TCM-acupuncture was associated with greater depression improvement than selective serotonin reuptake inhibitors.
Association between changes in estradiol, serotonin, and BDNF and antidepressant response in perimenopausal depression: a retrospective cohort study comparing integrated TCM-acupuncture with SSRIs.
Perimenopausal depression (perimenopausal depression) involves complex neuroendocrine interactions among estradiol (E 2 ), serotonin (5-HT), and brain-derived neurotrophic factor (brain-derived neurotrophic factor).
We conducted a single-center retrospective cohort study in 240 perimenopausal women (traditional Chinese medicine and acupuncture, n = 120; selective serotonin reuptake inhibitors, n = 120) treated for a minimum of eight weeks.
Traditional Chinese medicine and acupuncture resulted in greater depression improvement than selective serotonin reuptake inhibitors
Traditional Chinese medicine and acupuncture was also associated with greater increases in 5-HT (adjusted β = 9.24 ng/mL, 95% CI 6.92-11.56; P < 0.001) and brain-derived neurotrophic factor (adjusted β = 1.60 ng/mL, 95% CI 0.95-2.25; P < 0.001).
Unadjusted estradiol levels did not differ significantly between groups (P = 0.592).
Across the full cohort, changes in 5-HT and brain-derived neurotrophic factor were positively associated with HAMD-17 improvement (Spearman ρ = 0.31 and 0.37, respectively), with the brain-derived neurotrophic factor-HAMD-17 association being more pronounced in the traditional Chinese medicine and acupuncture group on interaction testing.
In multivariable-adjusted analyses, traditional Chinese medicine and acupuncture was associated with greater HAMD-17 improvement and more pronounced increases in 5-HT and brain-derived neurotrophic factor compared to selective serotonin reuptake inhibitors, while both treatments showed minimal differential effects on estradiol.
However, absolute response rates were low in both groups, and the between-group difference reflects a relative rather than absolute clinical advantage.