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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.

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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.

Release available online at http://www.uphs.upenn.edu/news/News_Releases/feb04/PMS.htm