OBJECTIVE: The aim of this study was to investigate which add-back hormone replacement therapy would be most beneficial in terms of mood effects for patients with premenstrual dysphoric disorder who are receiving gonadotropin-releasing hormone agonist therapy. STUDY DESIGN: Three different add-back hormone replacement treatments were evaluated in a randomized, double-blinded, cross-over clinical trial in 27 patients premenstrual dysphoric disorder. The add-back treatments consisted of 1.5 mg estradiol and 400 mg progesterone, 1.5 mg estradiol and placebo, and 0.5 mg estradiol and 400 mg progesterone. The primary outcome measure was daily symptom ratings for mood and physical symptoms. RESULTS: The highest dose of estradiol in combination with progesterone was associated with the most pronounced symptom recurrence, both in comparison with a lower dose of estradiol together with progesterone and estradiol-only treatment. CONCLUSION: Based on the findings of the present study, long-cycle add-back treatment to avoid frequent progestagen use appears to be most beneficial for patients with premenstrual dysphoric disorder.
RCT Entities:
OBJECTIVE: The aim of this study was to investigate which add-back hormone replacement therapy would be most beneficial in terms of mood effects for patients with premenstrual dysphoric disorder who are receiving gonadotropin-releasing hormone agonist therapy. STUDY DESIGN: Three different add-back hormone replacement treatments were evaluated in a randomized, double-blinded, cross-over clinical trial in 27 patients premenstrual dysphoric disorder. The add-back treatments consisted of 1.5 mg estradiol and 400 mg progesterone, 1.5 mg estradiol and placebo, and 0.5 mg estradiol and 400 mg progesterone. The primary outcome measure was daily symptom ratings for mood and physical symptoms. RESULTS: The highest dose of estradiol in combination with progesterone was associated with the most pronounced symptom recurrence, both in comparison with a lower dose of estradiol together with progesterone and estradiol-only treatment. CONCLUSION: Based on the findings of the present study, long-cycle add-back treatment to avoid frequent progestagen use appears to be most beneficial for patients with premenstrual dysphoric disorder.
Authors: Peter J Schmidt; Pedro E Martinez; Lynnette K Nieman; Deloris E Koziol; Karla D Thompson; Linda Schenkel; Paul G Wakim; David R Rubinow Journal: Am J Psychiatry Date: 2017-04-21 Impact factor: 18.112
Authors: Tracy Nevatte; Patrick Michael Shaughn O'Brien; Torbjorn Bäckström; Candace Brown; Lorraine Dennerstein; Jean Endicott; C Neill Epperson; Elias Eriksson; Ellen W Freeman; Uriel Halbreich; Khalid Ismail; Nicholas Panay; Teri Pearlstein; Andrea Rapkin; Robert Reid; David Rubinow; Peter Schmidt; Meir Steiner; John Studd; Inger Sundström-Poromaa; Kimberly Yonkers Journal: Arch Womens Ment Health Date: 2013-04-27 Impact factor: 3.633