Predictors of Response to Sertraline Treatment of Severe Premenstrual Syndromes

Background: Serotonergic antidepressantmedications have demonstrated efficacy in the treatment of severepremenstrual syndrome (PMS) and premenstrual dysphoric disorder(PMDD). Over 60% of subjects responded well to sertralinetreatment for PMS and PMDD in double-blind controlled studies.However, no studies have evaluated the predictors of treatmentresponse for this disorder. The current study examinedpretreatment demographic, medical history, and clinical symptompredictors of sertraline response in PMS and PMDD treatment.

Method: Sixty-two subjects diagnosed with severePMS (according to the Daily Symptom Report and global ratings offunctional impairment) or PMDD (DSM-IV) received sertralinetreatment as part of a randomized, double-blind,placebo-controlled treatment efficacy study. All subjectscompleted 3 screening cycles, including a single-blind placebowashout cycle, prior to 3 cycles of double-blind treatment.Outcome was assessed across the domains of PMS symptoms andquality of life. Demographic, medical history, and symptomvariables were used to predict sertraline response.

Results: Baseline postmenstrual symptom ratingswere significantly and independently associated withposttreatment PMS symptoms in multivariate analysis. Premenstrualand postmenstrual ratings of depression, medical historyvariables, and demographic variables were not significantlypredictive of response to sertraline.

Conclusion: Baseline postmenstrual symptomratings controlled for baseline premenstrual symptoms wereassociated with PMS symptoms at sertraline treatment endpoint.The findings suggest that non-menstrual-related baselinecharacteristics other than depression may influence sertralinetreatment outcome in patients with higher postmenstrual symptomlevels.