 |
|
Differential Response to Antidepressants in Women With Premenstrual Syndrome/Premenstrual Dysphoric Disorder
A Randomized Controlled Trial
Ellen W. Freeman, PhD;
Karl Rickels, MD;
Steven J. Sondheimer, MD;
Marcia Polansky, ScD
Arch Gen Psychiatry. 1999;56:932-939.
Background Studies show that selective serotonin reuptake inhibitors are effective for severe premenstrual syndrome and premenstrual dysphoric disorder. This study compares the efficacy of a selective serotonin reuptake inhibitor with that of a tricyclic antidepressant to determine whether efficacy for premenstrual syndrome/premenstrual dysphoric disorder is a general or more serotonergic effect of antidepressants.
Methods After 3 screening months, 189 subjects were randomized to sertraline hydrochloride, desipramine hydrochloride, or placebo for 3 months of double-blind treatment. The flexible dosage range was 50 to 150 mg/d. The outcome measures included the Penn Daily Symptom Report (DSR), the Hamilton Depression Rating Scale, the Clinical Global Impressions–Severity Scale, the Quality of Life Scale, and Patient Global Ratings of Functioning and Improvement. Analyses included all subjects with treatment data, with the last observation carried forward.
Results Sertraline was significantly more effective than placebo or desipramine; desipramine was not better than placebo (F2,163=12.47, P<.001). All DSR factors were more improved with sertraline compared with desipramine and placebo; the factors for mood (P<.001) and pain (P=.05) were significant, and the results of all outcome measures were consistent. A history of depression, postmenstrual symptom levels, and other diagnostic variables added individually as covariates did not alter the treatment results. At end point analysis, DSR symptoms had decreased by more than 50% in 40 subjects (65%) in the sertraline group, 18 subjects (36%) in the desipramine group, and 16 subjects (29%) in the placebo group (P<.001).
Conclusions The comparison of 2 classes of antidepressants strongly favored the serotonergic drug, which effectively reduced symptoms and improved functioning and was well tolerated by women with severe premenstrual syndrome. A history of depression did not alter the treatment results.
From the Departments of Obstetrics/Gynecology (Drs Freeman, Rickels, and Sondheimer) and Psychiatry (Drs Freeman and Rickels), School of Medicine, University of Pennsylvania, Philadelphia; and School of Public Health, Medical College of Pennsylvania, Hahnemann University, Philadelphia (Dr Polansky).
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Management Strategies for Premenstrual Syndrome/Premenstrual Dysphoric Disorder
Jarvis et al.
The Annals of Pharmacotherapy 2008;42:967-978.
ABSTRACT
| FULL TEXT
Selective Serotonin Reuptake Inhibitors for Premenstrual Syndrome and Premenstrual Dysphoric Disorder: A Meta-Analysis
Shah et al.
Obstet Gynecol 2008;111:1175-1182.
ABSTRACT
| FULL TEXT
Duloxetine for the Treatment of Major Depressive Disorder in Women Ages 40 to 55 Years
Burt et al.
Psychosomatics 2005;46:345-354.
ABSTRACT
| FULL TEXT
Premenstrual Syndrome, Premenstrual Dysphoric Disorder, and Beyond: A Clinical Primer for Practitioners
Johnson
Obstet Gynecol 2004;104:845-859.
ABSTRACT
| FULL TEXT
Premenstrual Exacerbation of Depressive Disorders In a Community-Based Sample in the United States
Hartlage et al.
Psychosom. Med. 2004;66:698-706.
ABSTRACT
| FULL TEXT
Treatment of Somatoform Disorders With St. John's Wort: A Randomized, Double-Blind and Placebo-Controlled Trial
Muller et al.
Psychosom. Med. 2004;66:538-547.
ABSTRACT
| FULL TEXT
Premenstrual Syndrome as a Predictor of Menopausal Symptoms
Freeman et al.
Obstet Gynecol 2004;103:960-966.
ABSTRACT
| FULL TEXT
Continuous or Intermittent Dosing With Sertraline for Patients With Severe Premenstrual Syndrome or Premenstrual Dysphoric Disorder
Freeman et al.
Am. J. Psychiatry 2004;161:343-351.
ABSTRACT
| FULL TEXT
Premenstrual Dysphoric Disorder
Grady-Weliky
NEJM 2003;348:433-438.
FULL TEXT
Efficacy of Intermittent, Luteal Phase Sertraline Treatment of Premenstrual Dysphoric Disorder
Halbreich et al.
Obstet Gynecol 2002;100:1219-1229.
ABSTRACT
| FULL TEXT
A Management Model for Pediatric Somatization
Campo and Fritz
Psychosomatics 2001;42:467-476.
ABSTRACT
| FULL TEXT
Treatments for premenstrual dysphoric disorder
Carr
Fam Pract 2001;18:644-646.
FULL TEXT
Venlafaxine in the Treatment of Premenstrual Dysphoric Disorder
Freeman et al.
Obstet Gynecol 2001;98:737-744.
ABSTRACT
| FULL TEXT
Plasma leptin concentrations are increased in women with premenstrual syndrome
Anim-Nyame et al.
Hum Reprod 2000;15:2329-2332.
ABSTRACT
| FULL TEXT
Sertraline was more effective than desipramine or placebo for premenstrual syndrome
Haynes
Evid. Based Ment. Health 2000;3:45-45.
FULL TEXT
Not Just Any Antidepressant for PMS
JWatch Women's Health 1999;1999:1-1.
FULL TEXT
|
