Livia Mitsue Gomes Yukizaki
Graduanda de Medicina da Universidade Federal do Rio de Janeiro (UFRJ).
André Barciela Veras
Mestrando do Programa de Pós-Graduação do Instituto de Psiquiatria da UFRJ
Flávia Schueler Franco, Luisa Duarte Novo
Graduanda de Medicina da Universidade Federal do Rio de Janeiro (UFRJ)
Arabella Rassi
Aluna do estágio probatório para Mestrado do Programa de Pós-Graduação do Instituto de Psiquiatria da UFRJ
Antonio Egídio Nardi
Professor adjunto do Instituto de Psiquiatria da Faculdade de Medicina da UFRJ.

Abstract:

Background: The relevance of this clinical case report is to emphasize the importance of the use of nortryptiline for major depression after endometriosis treatment. Objective: To describe by a case report the relationship between treatment for endometriosis and psychiatric disorders. We will also describe the therapeutic response to nortriptyline. Methods: Psychiatric interview and periodical clinical psychiatric evaluation for the treatment of a patient in the Outpatient Unit of the Institute of Psychiatry of the Federal University of Rio de Janeiro. Results: An outpatient, fifty-five year-old woman with major depression treated in the Psychiatric Institute of Federal University of Rio de Janeiro. She was being treated for endometriosis with goserelin for hormone suppression when she started to complain of depressive and anxiety symptoms. The patient did not improve with 20 mg/day of fluoxetine for 8 weeks. She improved after 2 weeks using 25 mg/day of nortryptiline. The improvement persisted during our 16 weeks follow-up. Conclusion: Although only sertraline has its efficacy demonstrated for depressive symptoms associated with ovarian suppression, in this case nortriptyline was efficient too. We observed the necessity of more studies about this topic in order to better evaluate other therapeutic options.

Keywords:Endometriosis, goserelin, nortriptyline, depression, anxiety