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February 2, 2004
No Difference Seen In Intermittent versus Continual
Use of Anti-Depressant to Treat
Severe Premenstrual Syndrome
Patients Could Benefit From Decreased Side Effects
and Lower Drug Costs, Exposure
(Philadelphia, PA) -- The laundry list of premenstrual
symptoms--bloating, irritability, and mood swings--is
all too familiar to most women. Thankfully it passes
each month and is manageable along with life’s
other stresses. But for some women these premenstrual
(PMS) symptoms have become too overwhelming, even debilitating,
for weeks out of every menstrual cycle. Anti-depressants
such as Zoloft (sertraline) have been shown to increase
the levels of certain brain chemicals and are used to
counteract the irritability, anxiety, and other symptoms
associated with severe PMS and premenstrual dysphoric
disorder (PMDD). Zoloft and other SSRIs (selective serotonin
reuptake inhibitors) are thought to increase the availability
of serotonin, a neurotransmitter associated with feelings
of well being, to brain cells, thereby alleviating the
symptoms.
“Our interest was whether women could take these
medications just during the premenstrual time instead
of daily,” says Ellen Freeman, PhD,
research professor of obstetrics and gynecology at the
University of Pennsylvania School of Medicine.
Freeman and colleagues tested whether continuous or
intermittent use of sertraline was better for patients
with severe PMS. Their results appear in the February
2004 issue of The American Journal of Psychiatry.
They found that part-time and full-time use of an SSRI
to treat PMS are equally effective in reducing symptoms.
Although many women are already trying a part-time regime,
Freeman states that now there’s “clear-cut
evidence that part-time use is just as good.”
The intermittent regime means less exposure to drugs,
less cost, and decreased short- and long-term side effects.
Short-term initial side effects are much the same if
SSRIs are taken full- or part-time, but long-term effects
such as deceased libido, could be less adverse with
an intermittent regime. “That could be seen as
an advantage,” says Freeman.
Study participants marked their symptoms and severity
in a uniform daily symptom report. For this study, intermittent
dosing is defined as from day 14 of the menstrual cycle
to day two of the next cycle, although the timing of
premenstrual symptoms varies from woman to woman.
Scientists also contributing to this research are Karl
Rickels, M.D., Steven Sondheimer, M.D., and Sha Xiao
from Penn and Marcia Polansky, Sc.D. from Drexel University.
This study was funded by the National Institutes of
Health. Dr. Freeman can be reached at 215-662-3329 or
freemane@mail.med.upenn.edu.
For
a printer friendly version of this release, click
here.
# # #
PENN Medicine is
a $2.2 billion enterprise dedicated to the related missions
of medical education, biomedical research, and high-quality
patient care. PENN Medicine consists of the University
of Pennsylvania School of Medicine (founded in 1765
as the nation’s first medical school) and the
University of Pennsylvania Health System (created in
1993 as the nation’s first integrated academic
health system).
Penn’s School of Medicine is ranked #2 in the
nation for receipt of NIH research funds; and ranked
#4 in the nation in U.S. News & World Report’s
most recent ranking of top research-oriented medical
schools. Supporting 1,400 fulltime faculty and 700 students,
the School of Medicine is recognized worldwide for its
superior education and training of the next generation
of physician-scientists and leaders of academic medicine.
Penn Health System consists of four hospitals (including
its flagship Hospital of the University of Pennsylvania,
consistently rated one of the nation’s “Honor
Roll” hospitals by U.S. News & World Report),
a faculty practice plan, a primary-care provider network,
three multispecialty satellite facilities, and home
health care and hospice.
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