A Preliminary Study of Luteal Phase Versus Symptom-Onset Dosing With Escitalopram for Premenstrual Dysphoric Disorder

Ellen W. Freeman, PhD; Steven J. Sondheimer, MD;  Mary D. Sammel, ScD; Tahmina Ferdousi, PhD; and Hui Lin, MS

Published: June 15, 2005

Article Abstract

Objective: This preliminary study comparedthe efficacy and tolerability of escitalopram administeredat symptom onset or throughout theluteal phase in premenstrual dysphoric disorder(PMDD).

Method: Twenty-seven women meetingDSM-IV criteria for PMDD were randomly assignedin a double-blind manner to luteal phase(N = 13) or symptom-onset (N = 14) dosing ofescitalopram (10-20 mg/day) for 3 consecutivemenstrual cycles. Participants were enrolled fromNovember 2002 to July 2003, and data collectionwas completed in December 2003. Symptomswere assessed using the 17-item Penn DailySymptom Report (DSR), the Clinical GlobalImpressions-Improvement scale, the HamiltonRating Scale for Depression, and the SheehanDisability Scale. Scores were compared usingrepeated measures analysis of covariance andt statistics.

Results: Luteal phase and symptom-onsetgroups received escitalopram for a mean of 13.5and 6.0 days, respectively (mean ± SD dose =15.2 ± 5.1 mg/day at the third treatment cycle).Total premenstrual DSR scores significantlyimproved from baseline (p = .003), with a 57%decrease in the luteal phase group and a 51%decrease in the symptom-onset group. Clinicalimprovement (DSR score decrease ≥ 50% frombaseline) was reported by 11 of 13 patients inthe luteal phase group and 9 of 14 patients inthe symptom-onset group. Symptom severitydifferentiated the response in the symptom-onsetgroup, with those having more severe symptomsless likely to respond. Symptom severity didnot differentiate treatment response to lutealphase dosing. Escitalopram was well tolerated.Adverse events were mild and transient, withonly 2 patients discontinuing due to adverseevents related to the medication.

Conclusion: Premenstrual dysphoric disorderimproved significantly with either luteal phase orsymptom-onset dosing of escitalopram. Womenwith more severe PMDD may respond better toluteal phase dosing than symptom-onset dosing.’ ‹

Volume: 66

Quick Links: Depression (MDD) , Premenstrual Dysphoric Disorder

Continue Reading…

Subscribe to read the entire article

$40.00

Buy this Article as a PDF

Sign-up to stay
up-to-date today!

SUBSCRIBE

Already registered? Sign In

Original Research

Frontothalamic Circuit Abnormalities in Patients With Bipolar Depression and Suicide Attempts

To identify potential markers for suicide risk, this fMRI study looked at neural activity in bipolar depression...

Read More...