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Randomised trial, 2006

Does low-dose sertraline help moderate-to-severe PMS when used in different dosing patterns?

Yes. Low-dose sertraline (25 or 50 mg/day) significantly improved PMS symptoms with multiple dosing patterns: taking it only during the second half of the cycle, all month, or starting when symptoms begin.

Strong study design 314 women with moderate-to-severe PMS from 22 U.S. sites

What they did

RCT of 314 women with moderate-to-severe PMS from 22 U.S. sites. Women received sertraline 25 mg/day, sertraline 50 mg/day, or placebo for 4 menstrual cycles after a 1-cycle placebo lead-in. Three dosing strategies were tested: taking it only during the second half of the cycle for 2 cycles, taking it all month for 1 cycle, and taking it starting when symptoms appear for 1 cycle.

What they found

Low-dose sertraline (both 25 and 50 mg/day) significantly reduced PMS symptoms compared to placebo when taken during the second half of the cycle only. Continuous dosing and symptom-onset dosing also worked, especially at the 25 mg/day dose. Improvements were seen in daily symptom reports, symptom severity, overall improvement, quality of life, and social adjustment.

What it means for you

Sertraline at low doses is safe and effective for moderate-to-severe PMS. Women don't need to take it every day of the month. The 25 mg/day dose was particularly effective, suggesting very low doses may be sufficient. The main limit is that this study was conducted only in U.S. sites.

314

women

25 or 50 mg/day

sertraline dose

4

menstrual cycles of treatment

About the study

Original title
Low-dose sertraline in the treatment of moderate-to-severe premenstrual syndrome: efficacy of 3 dosing strategies
Authors
Kornstein SG, Pearlstein TB, Fayyad R et al.
Journal
The Journal of clinical psychiatry
Year
2006
Study design
Randomised trial
Participants
314
What was tested
Sertraline 25 or 50 mg/day or placebo for 4 cycles: luteal phase only, continuous, or symptom-onset dosing

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