Predictors of Response to Sertraline Treatment of Severe Premenstrual Syndromes
J Clin Psychiatry 2000;61(8):579-584
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Serotonergic antidepressant
medications have demonstrated efficacy in the treatment of severe
premenstrual syndrome (PMS) and premenstrual dysphoric disorder
(PMDD). Over 60% of subjects responded well to sertraline
treatment for PMS and PMDD in double-blind controlled studies.
However, no studies have evaluated the predictors of treatment
response for this disorder. The current study examined
pretreatment demographic, medical history, and clinical symptom
predictors of sertraline response in PMS and PMDD treatment.
Method: Sixty-two subjects diagnosed with severe
PMS (according to the Daily Symptom Report and global ratings of
functional impairment) or PMDD (DSM-IV) received sertraline
treatment as part of a randomized, double-blind,
placebo-controlled treatment efficacy study. All subjects
completed 3 screening cycles, including a single-blind placebo
washout cycle, prior to 3 cycles of double-blind treatment.
Outcome was assessed across the domains of PMS symptoms and
quality of life. Demographic, medical history, and symptom
variables were used to predict sertraline response.
Results: Baseline postmenstrual symptom ratings
were significantly and independently associated with
posttreatment PMS symptoms in multivariate analysis. Premenstrual
and postmenstrual ratings of depression, medical history
variables, and demographic variables were not significantly
predictive of response to sertraline.
Conclusion: Baseline postmenstrual symptom
ratings controlled for baseline premenstrual symptoms were
associated with PMS symptoms at sertraline treatment endpoint.
The findings suggest that non-menstrual-related baseline
characteristics other than depression may influence sertraline
treatment outcome in patients with higher postmenstrual symptom