Intermittent luteal phase sertraline treatment of dysphoric premenstrual syndrome.
BACKGROUND
Dysphoric premenstrual syndrome (PMS) has been associated with serotonergic dysregulation, and serotonergic medications have been reported to alleviate the symptoms of PMS. We investigated the effects of the serotonin reuptake inhibitor sertraline given during only the luteal phase in women with dysphoric PMS.


METHODS
After baseline ratings were obtained during two menstrual cycles, 15 women with dysphoric PMS who also met DSM-IV criteria for premenstrual dysphoric disorder (PMDD) entered single-blind treatment with sertraline 100 mg/day for one full menstrual cycle. Women who responded to this treatment were randomly assigned to a four-cycle double-blind placebo-controlled crossover study in which sertraline 100 mg/day or placebo was each given only during luteal phases of two consecutive menstrual cycles.


RESULTS
Eleven (79%) of fourteen women responded to single-blind full-cycle treatment with sertraline and were randomly assigned to the double-blind crossover study. Three patients dropped out of the study while taking placebo owing to nonresponse. For the remaining patients, sertraline given during the luteal phase produced significant improvements in depression, impairment, and global ratings compared with placebo and was equivalent in efficacy to sertraline given during the entire menstrual cycle.


CONCLUSIONS
Women with dysphoric PMS who responded to continuous sertraline treatment responded equally well to sertraline treatment that was restricted to the luteal phase. Luteal phase treatment may have advantages in side effect burden and costs. Larger controlled trials are warranted to confirm this finding.
Halbreich
U
U
Biobehavioral Program, State University of New York (SUNY) Clinical Center, Buffalo 14215, USA.
Smoller
J W
JW
D015057:1-Naphthylamine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008183:Luteal Phase; D008597:Menstrual Cycle; D008875:Middle Aged; D010919:Placebos; D011293:Premenstrual Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D020280:Sertraline; D016037:Single-Blind Method; D016896:Treatment Outcome
D015057:1-Naphthylamine; D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline