Symptom-Onset Dosing of Sertraline for the Treatment of Premenstrual Dysphoric Disorder

Making Strides to Simplify Diagnosis of Premenstrual Dysphoric Disorder

“…However, inclusion of these individuals in research focusing on the pathophysiology and treatment of PMDD hinders scientific advancement. Moreover, treatment during the luteal phase or at symptom onset with selective serotonin reuptake inhibitors, which have shown effectiveness in the treatment of PMDD, may not be appropriate for individuals with other MRMDs (7, 8). …”

Treatment of Premenstrual Dysphoric Disorder: Therapeutic Challenges

“…An RCT evaluating symptom-onset dosing recently reported that sertraline 50-100 mg daily taken on symptomatic premenstrual days (average 6 days) was superior to placebo on some rating scales in 252 women with PMDD, with particular benefit for irritability and anger [11]. Studies involving intermittent dosing have reported the absence of discontinuation symptoms when the antidepressant is abruptly stopped the first day of menses.…”

“…Future studies are indicated to systematically compare the efficacy and predictors of response to symptom-onset, luteal phase, and continuous daily SSRI dosing in women with PMDD. It is possible that the irritability/ anger/mood swings subtype of PMDD is differentially responsive to treatments that lead to a quick change in ALLO availability or function, for example, symptomonset SSRI [11] or dutasteride [7]. Women with prominent depressive symptoms or physical symptoms may require longer duration of SSRI treatment during the cycle [5].…”

Premenstrual dysphoric disorder: General overview, treatment strategies, and focus on sertraline for symptom-onset dosing

“…[20] described a large ( n = 252), industry-independent, three-center RCT of sertraline ( n = 125) versus placebo ( n = 127) in women with prospectively confirmed PMDD. No woman had significant medical or psychiatric comorbidities.…”

“…Another is the strategy to be adopted in women who fail to respond to targeted, symptom-onset sertraline in the dose employed by Yonkers et al . ;[20] should a higher dose be employed, should a different drug be trialed, or should women be advised treatment during the luteal phase or even during the entire menstrual cycle?…”