--- title: Do women with depression whose symptoms worsen before their period respond differently to antidepressants? description: About two-thirds of depressed women report premenstrual worsening, and these women tend to have more chronic depression and medical problems. However, premens url: https://niyora.com/research/papers/the-clinical-relevance-of-self-reported-premenstrual-worsening-of-depressive-2013/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Do women with depression whose symptoms worsen before their period respond differently to antidepressants? 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. Moderate study design 545 premenopausal women with major depression not using hormonal contraceptives, from the STAR*D depression treatment trial ## 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](https://doi.org/10.1089/jwh.2011.3186) ## Topics [Premenstrual exacerbation (PME)](https://niyora.com/research/topics/condition-pme/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[Oral contraceptives and drospirenone](https://niyora.com/research/topics/treatment-hormonal-contraceptives/)[Major depressive disorder](https://niyora.com/research/topics/comorbidity-major-depression/)[Perimenopause and menopause](https://niyora.com/research/topics/comorbidity-perimenopause/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Study, 2005 Do women with depression experience worsening of symptoms before their period? Randomised trial, 2017 Does adding birth control to antidepressants help depression that worsens before your period? Randomised trial, 2007 Do birth control pills help depression that worsens before the period in women on antidepressants? Survey study, 2006 Does the menstrual cycle affect how severe OCD symptoms are? Randomised trial, 2001 Do changing reproductive hormones disrupt the body's internal clock and cause mood disorders? Review, 2024 What are the most effective treatments for PMDD? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗