Some premenstrual symptoms improve with antidepressants

Researchers at the University of Pennsylvania found that of 447 women who participated in clinical trials evaluating the use of sertraline (Zoloft) for the SPM, those with symptoms "varied" from physical to psychological,-were the most likely to see an improvement.

In contrast, women with primarily physical symptoms received little help, except that they had severe swelling or severe breast tenderness, said in the journal Obstetrics & Gynecology.

"There is a huge range of symptoms of PMS, and a huge range of severity of them," said Ellen Freeman , research professor of obstetrics and gynecology at the University of Pennsylvania in Philadelphia .

Many women have symptoms such as swelling, tenderness extreme breast tenderness, headaches and emotional stress shortly before their menstrual periods. Often, simple is solved with changes in diet, exercise and counter analgesics.

But in some cases, the PMS is severe enough to disrupt daily life and then you can indicate the use of antidepressants known as selective inhibitors of serotonin reuptake inhibitors (SSRIs).

Studies have found that antidepressants may help some women with PMS or premenstrual dysphoric disorder (PMDD), a severe form of PMS that affect a small percentage of patients.

However, about 40 percent of women who test treatments with SSRIs do not get benefits.

Freeman, who received funding from various manufacturers of antidepressants, said that no SSRIs are approved for the treatment of PMS, but doctors can prescribe for premenstrual symptoms and clinical trials have included women with both severe PMS and PMDD most severe form .

Freeman's team focused on 447 women with PMS or PMDD who were randomly assigned to take sertraline or an inactive placebo. Most had a subtype "mixed" PMS and PMDD, with significant physical and psychological symptoms.

Almost two thirds of patients treated with the drug reported a 50 percent improvement in their symptoms over three menstrual cycles, compared with 42 percent of women who received placebo.

But the antidepressant was less effective in women with primarily physical symptoms.

"His physical symptoms really seemed not to respond, unless they were severe breast tenderness or swelling," said Freeman.

The expert said the study only looked at the action of sertraline, so it is not possible to say with certainty whether the findings would apply to other SSRIs, although it probably is.

Freeman added that as with any medication, a woman should weigh the potential benefits of treatment against the risks of side effects when treated with SSRIs.

One of the colleagues of the author who participated in the research was funded by Pfizer Inc, which markets Zoloft. Freeman received funds from several other laboratories.