Gonadotropin-releasing hormone agonist in treatment of premenstrual symptoms with and without comorbidity of depression: a pilot study.
BACKGROUND
Gonadotropin-releasing hormone agonist (GnRHa) in depot form for once-a-month rather than daily injection was examined in a small open trial to determine the extent of reduction of premenstrual symptoms, particularly premenstrual "depression."


METHODS
Women who met criteria for premenstrual syndrome (PMS) or for PMS with comorbidity of major depression (MD), based on DSM-III-R criteria, were evaluated for the study. Evaluation included Structured Clinical Interview for DSM-III-R, administered in the follicular phase, and Daily Symptom Report (DSR), maintained throughout the study. Seven PMS subjects and two subjects who met the severity and change criteria for PMS but had concurrent MD were administered 3.75 mg of depot leuprolide monthly. Symptom change as reported on the DSR was compared with the untreated baseline scores.


RESULTS
Six of seven PMS subjects had cessation of menses and significant decreases in premenstrual symptoms (p < .0001), which were reduced to their follicular phase levels. Physical symptoms of swelling and breast tenderness were among the most improved symptoms. Despite cessation of menses, the two MD subjects showed little improvement in premenstrual symptoms and no improvement in depressive symptoms. The premenstrual depression scores decreased almost completely in the PMS subjects, but increased slightly in the MD subjects.


CONCLUSIONS
This small open trial suggests that GnRH agonist therapy reduces premenstrual symptoms including "depression" in women who meet criteria for PMS but not in women with PMS and MD. Further controlled study of the role of ovarian function in mood disorders is needed.
Department of Obstetrics/Gynecology, University of Pennsylvania, Philadelphia.
E W
EW
Freeman
S J
SJ
Sondheimer
K
K
Rickels
J
J
Albert
D000328:Adult; D015897:Comorbidity; D003692:Delayed-Action Preparations; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage / Q000627:therapeutic use*; D010865:Pilot Projects; D011293:Premenstrual Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales
D003692:Delayed-Action Preparations; D016729:Leuprolide