Table 2.
SNRIs for depressive and anxiety symptoms during the menopausal transition and postmenopause
| Author (Year) | Country | Design | N | Population / Menopausal Stage | Intervention | Comparator | Mood Assessment Tool | Diagnostic Criteria | Duration | Primary Outcome(s) | Key Findings |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Kornstein et al. (2010) [27] | USA | Randomized, placebo-controlled trial | 387 | Perimenopausal and postmenopausal women with MDD | Desvenlafaxine 100–200 mg/day | Placebo | HAM-D17 | DSM-IV MDD | 8 weeks | Depressive symptoms | Significant reduction in HAM-D17 scores and higher response/remission rates compared with placebo. |
| Clayton et al. (2013) [28] | USA | Randomized, placebo-controlled trial | 363 | Perimenopausal and postmenopausal women with MDD | Desvenlafaxine 50 mg/day | Placebo | HAM-D17, MADRS, QIDS-SR | DSM-IV MDD | 8 weeks | Depressive symptoms | Significant improvements in depressive symptoms and remission outcomes compared with placebo. |
| Kulkarni et al. (2018) [29] | Australia | Randomized controlled trial | 80 | Perimenopausal women with depression | Desvenlafaxine-based treatment | Comparator regimen | MADRS | Clinical diagnosis of depression | 6 months | Depressive symptoms | Significant reduction in depressive symptom severity during follow-up. |
| Schneider et al. (2013) [30] | USA | Randomized controlled trial | 130 | Postmenopausal women with depression | Desvenlafaxine | Placebo | MADRS | MDD | 8 weeks | Depressive symptoms | Reduction in depressive symptom burden relative to placebo. |
| caan et al. (2015) [31] | USA | Randomized placebo-controlled trial | 339 | Perimenopausal and early postmenopausal women | Oral 17β-estradiol 0.5 mg/day (n = 97) or Venlafaxine XR 75 mg/day (n = 96) | Placebo (n = 146) | PHQ-9 (depressive symptoms), GAD-7 (anxiety symptoms), Perceived Stress Scale (PSS) | No DSM diagnosis required; women with major depressive episodes or severe psychiatric illness were excluded | 8 weeks | Menopause-specific Quality of Life (MENQOL) | Neither treatment produced significant improvements in depressive symptoms (PHQ-9) or anxiety symptoms (GAD-7). |
| Mahajan et al. (2022) [32] | India | Randomized, Open-label, Intention-to-Treat Trial | 40 | Postmenopausal women (40–65 years; natural or surgical menopause) with newly diagnosed depression and anxiety | Desvenlafaxine 50–100 mg/day | Escitalopram 10–20 mg/day | HAM-D | Clinical diagnosis of depression | 6 weeks | Depressive symptoms | Both groups improved; no clear superiority established. |
| Davari-Tanha et al. (2016) [33] | Iran | Randomized controlled trial | 60 | Postmenopausal women | Venlafaxine 75 mg/day | Citalopram and placebo | BDI | Postmenopausal depressive symptoms | 8 weeks | Depressive symptoms | No significant difference among study groups. |
Abbreviations: BDI, Beck Depression Inventory; HAM-D, Hamilton Depression Rating Scale; MADRS, Montgomery Åsberg Depression Rating Scale; MDD, Major Depressive Disorder; MENQOL, Menopause-Specific Quality of Life Questionnaire; QIDS-SR, Quick Inventory of Depressive Symptomatology Self Report