The role of cytokines and hot flashes in perimenopausal depression

Serum samples from 65 perimenopausal women, 41 with depression and 24 without depression, were assessed for serum IL-6, TNFα and IL-10 by conventional enzyme-linked immunosorbent assays. Depression was evaluated by the 17-item Hamilton Depression Rating Scale (HAM-D 17) and a psychiatric interview. The presence and severity of hot flashes were examined using the Menopause Rating Scale (MRS).Serum levels cytokines did not differ between depressed women and normal controls. Serum levels of cytokines did not change significantly in depressed women with hot flashes or in depressed women treated with SSRIs. Hot flashes were strongly associated (P < 0.0001) with perimenopausal depression.The study supports the hypothesis that perimenopausal depression is not characterized by increased proinflammatory cytokines and decreased anti-inflammatory cytokines. Women with perimenopausal depression suffer from more severe and more frequent hot flashes than women without perimenopausal depression.Throughout most of their lives, women are at greater risk of becoming depressed than men. The perimenopause and early postmenopausal period has been considered as 'window of vulnerability', during which emerging physical and emotional discomforts and hormonal changes can lead to the appearance of depression [1-3]. The mechanisms responsible for the development of depression in perimenopausal women remain unclear.Major depression, in general, is associated with inflammatory processes and neural-immune interactions [4-9]. Proinflammatory cytokines, such as interleukin 6 (IL-6) and tumor necrosis factor α (TNFα) have been considered as key neuromodulators of behavioral, neuroendocrine and neurochemical features of depressive disorders [10]. This view is supported by the frequent appearance of depressive features in cytokine-mediated chronic inflammatory responses, such as rheumatoid arthritis, and in cytokine-treated patients with cancer and chronic hepatitis C [11]. Administration of proinfla