Randomised trial, 2013
Do women with depression whose symptoms worsen before their period respond differently to antidepressants?
About two-thirds of depressed women report premenstrual worsening, and these women tend to have more chronic depression and medical problems. However, premenstrual worsening does not predict which antidepressants will work.
What they did
Analysis of data from 545 premenopausal women with major depression enrolled in the STAR*D depression treatment trial. Researchers compared women who reported their depression worsens before their period to those who don't. Women were treated with citalopram first, and if needed, moved to bupropion-SR, venlafaxine-XR, or sertraline.
What they found
66% of women reported depression got worse before their period. These women had more general medical conditions, more anxiety symptoms, longer-lasting depressive episodes, and shorter times to relapse (41.3 to 47.1 weeks). However, response and remission rates with citalopram were the same whether or not women reported premenstrual worsening. Premenstrual worsening also didn't predict differential benefit between sertraline and bupropion-SR.
What it means for you
Premenstrual worsening of depression is very common and indicates a more chronic course of illness. However, since it does not predict antidepressant response, clinicians cannot use it to choose which medication to start. This finding limits its usefulness in clinical practice.
66%
Women reporting premenstrual worsening
545
Women analyzed
41.3-47.1 weeks
Time to relapse
About the study
- Original title
- The clinical relevance of self-reported premenstrual worsening of depressive symptoms in the management of depressed outpatients: a STAR*D report
- Authors
- Haley CL, Sung SC, Rush AJ et al.
- Journal
- Journal of women's health (2002)
- Year
- 2013
- Study design
- Randomised trial
- Participants
- 545
- What was tested
- Antidepressant medications (citalopram first, then bupropion-SR, venlafaxine-XR, or sertraline)
- Open access
- Yes
- Read the paper
- doi.org/10.1089/jwh.2011.3186
Topics
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