Basic psychopharmacology of antidepressants, part 2: Estrogen as an adjunct to antidepressant treatment.

Estrogen exerts profound effects upon behavior by interacting with neuronal estrogen receptors. Changes in estrogen levels over a woman's life cycle are linked not only to behavioral fluctuations, but potentially to the onset or recurrence of mood disorders. The modern psychiatric evaluation of women requires obtaining a complete reproductive history, including details of hormone treatments, while identifying reproductive events as triggers of affective disorder episodes. While guidelines for the use of reproductive hormones in psychiatry are just evolving, administration of estrogen as an adjunct to antidepressants is an exciting possibility for expanding the frontiers of psychiatry into the field of women's health.