Paroxetine Increased the Serum Estrogen in Postmenopausal Women with Depressive and Anxiety Symptoms

Objective: Both of selective serotonin reuptake inhibitors (SSRIs) and estrogen can modulate emotion and cognition function in post-menopause women, moreover SSRIs can influence estrogen system in rats and aquatic wildlife but most of them for reproductive ability. The aim of this study was to investigate the possible relationship between SSRI, estrogen, and emotion and cognition in post-menopause women with anxiety and depressive symptoms .Methods: A double-blind, randomized controlled trials of Paroxetine, an SSRI (n = 44), versus placebo (n = 38) for 6 months in post-menopausal women with anxiety and depressive symptoms. For screening anxiety, depression and mild cognitive impairment (MCI), we use the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D) and the Chinese Version of the Montreal cognitive assessment (MoCA-CV). And sex hormones were measured by ELASE method which is serum estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH). Results: Paroxetine increased serum E2 and decreased LH, FSH significantly (P < 0.05). Meanwhile, HAM-A and HAM-D scores declined and MoCA-CV score raised by Paroxetine (P < 0.05). We also found that a negative association between E2 and scores of HAM-A and HAM-D at pre-treatment and post-treatment of Paroxetine (HAM-A: R = −0.27, R = −0.24; HAM-D: R = −0.65, R = −0.37), while a positive correlation between E2 and MoCA-CV scores (R = 0.52, R = 0.47). Conclusions: This founding suggests that SSRI can increase serum estrogen levels and the change of estrogen may be one of mechanism in SSRI’s improve emotion and cognitive function in post-menopausal women.