Researcher helps to discover a more convenient and efficient treatment for premenstrual dysphoric disorder

Confining antidepressant treatment for premenstrual dysphoric disorder to only the days that women are symptomatic is effective at lessening the condition's symptoms, according to a collaborative study from researchers at Virginia Commonwealth University, Yale University and Cornell University.

"Many women who have PMDD prefer to take their antidepressant medication for as few days as needed during the month," said Susan G. Kornstein, M.D., professor, Department of Psychiatry, VCU School of Medicine and principal investigator at the VCU site. "Symptom-onset dosing allows them to restrict their medication use to only the days that they have premenstrual symptoms. It also offers the advantage of lower cost and fewer concerns about long-term side effects such as weight gain or sexual dysfunction." Antidepressants have previously been shown to be effective for PMDD when taken either every day throughout the month or for the last two weeks of the menstrual cycle.

Premenstrual dysphoric disorder is a condition in which a woman has severe depressive symptoms, irritability and tension before menstruation. Symptoms occur during the week just before menstrual bleeding and usually improve within a few days after the period starts. PMDD is a severe form of premenstrual syndrome (PMS). According to the National Institutes of Health, PMDD affects between 3 and 8 percent of women during the years when they are having menstrual periods.

Kornstein collaborated on the study with Kimberly Yonkers, M.D., professor, Yale School of Public Health, and Margaret Altemus, adjunct associate professor, Weill Cornell Medical College. The study, "Symptom-Onset Dosing of Sertraline for the Treatment of Premenstrual Dysphoric Disorder," was published Sept. 9 as an advanced online publication in JAMA Psychiatry, a monthly, peer-reviewed medical journal published by the American Medical Association.

The executive director of the VCU Institute for Women's Health, Kornstein and her colleagues received funding from the National Institute of Mental Health to conduct the first large placebo-controlled randomized clinical trial of symptom-onset treatment with an antidepressant for PMDD. Sertraline is a serotonin reuptake inhibitor used commonly on a daily basis to treat depression. In the study, 250 women diagnosed with PMDD took sertraline or a placebo for an average of six days a month during the premenstrual week over six menstrual cycles.

"This study supports the rapid therapeutic action of serotonin reuptake inhibitors for PMDD symptoms," Kornstein said.