OBJECTIVE: To determine the incidence, clinical and demographic correlates, and relationship to treatment outcome of self-reported premenstrual exacerbation of depressive symptoms in premenopausal women with major depressive disorder who are receiving antidepressant medication. METHOD: This post-hoc analysis used clinical trial data from treatment-seeking, premenopausal, adult female outpatients with major depression who were not using hormonal contraceptives. For this report, citalopram was used as the first treatment step. We also used data from the second step in which one of three new medications were used (bupropion-SR [sustained release], venlafaxine-XR [extended release], or sertraline). Treatment-blinded assessors obtained baseline treatment outcomes data. We hypothesized that those with reported premenstrual depressive symptom exacerbation would have more general medical conditions, longer index depressive episodes, lower response or remission rates, and shorter times-to-relapse with citalopram, and that they would have a better outcome with sertraline than with bupropion-SR. RESULTS: At baseline, 66% (n=545/821) of women reported premenstrual exacerbation. They had more general medical conditions, more anxious features, longer index episodes, and shorter times-to-relapse (41.3 to 47.1 weeks, respectively). Response and remission rates to citalopram, however, were unrelated to reported premenstrual exacerbation. Reported premenstrual exacerbation was also unrelated to differential benefit with sertraline and bupropion-SR. CONCLUSIONS: Self-reported premenstrual exacerbation has moderate clinical utility in the management of depressed patients, although it is not predictive of overall treatment response. Factors that contribute to a more chronic or relapsing course may also play a role in premenstrual worsening of major depressive disorder (MDD).
RCT Entities:
OBJECTIVE: To determine the incidence, clinical and demographic correlates, and relationship to treatment outcome of self-reported premenstrual exacerbation of depressive symptoms in premenopausal women with major depressive disorder who are receiving antidepressant medication. METHOD: This post-hoc analysis used clinical trial data from treatment-seeking, premenopausal, adult female outpatients with major depression who were not using hormonal contraceptives. For this report, citalopram was used as the first treatment step. We also used data from the second step in which one of three new medications were used (bupropion-SR [sustained release], venlafaxine-XR [extended release], or sertraline). Treatment-blinded assessors obtained baseline treatment outcomes data. We hypothesized that those with reported premenstrual depressive symptom exacerbation would have more general medical conditions, longer index depressive episodes, lower response or remission rates, and shorter times-to-relapse with citalopram, and that they would have a better outcome with sertraline than with bupropion-SR. RESULTS: At baseline, 66% (n=545/821) of women reported premenstrual exacerbation. They had more general medical conditions, more anxious features, longer index episodes, and shorter times-to-relapse (41.3 to 47.1 weeks, respectively). Response and remission rates to citalopram, however, were unrelated to reported premenstrual exacerbation. Reported premenstrual exacerbation was also unrelated to differential benefit with sertraline and bupropion-SR. CONCLUSIONS: Self-reported premenstrual exacerbation has moderate clinical utility in the management of depressedpatients, although it is not predictive of overall treatment response. Factors that contribute to a more chronic or relapsing course may also play a role in premenstrual worsening of major depressive disorder (MDD).
Authors: Ahsan Y Khan; Joe Carrithers; Sheldon H Preskorn; Rex Lear; Stephen R Wisniewski; A John Rush; Diane Stegman; Colleen Kelley; Karen Kreiner; Andrew A Nierenberg; Maurizio Fava Journal: Ann Clin Psychiatry Date: 2006 Apr-Jun Impact factor: 1.567
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Authors: Stephen R Wisniewski; A John Rush; G K Balasubramani; Madhukar H Trivedi; Andrew A Nierenberg Journal: J Psychiatr Pract Date: 2006-03 Impact factor: 1.325
Authors: Jon S Novick; Jonathan W Stewart; Stephen R Wisniewski; Ian A Cook; Radmila Manev; Andrew A Nierenberg; Jerrold F Rosenbaum; Kathy Shores-Wilson; G K Balasubramani; Melanie M Biggs; Sid Zisook; A John Rush Journal: J Clin Psychiatry Date: 2005-08 Impact factor: 4.384
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Authors: Lindsay R Standeven; Elizabeth Olson; Nicole Leistikow; Jennifer L Payne; Lauren M Osborne; Liisa Hantsoo Journal: Curr Psychiatry Rep Date: 2021-04-21 Impact factor: 5.285