Time to Relapse After Short-Term or Long-Term Sertraline Treatment for Severe Premenstrual Syndromes

Context—The duration of treatment after achieving a satisfactory response is an unanswered question in the treatment of premenstrual syndrome (PMS). This information is needed given the improvement provided by medication versus the side effects and costs of drugs. Objectives—Compare rates of relapse and time to relapse between short-term and long-term sertraline treatment administered in the luteal phase. Design—An 18-month survival study with a randomized, double-blind switch to placebo after 4 months or 12 months of sertraline treatment. Setting—Academic medical center. Participants—174 PMS/PMDD patients. Main Outcome Measure—Relapse, defined as symptoms returned to the entry criterion level assessed by daily ratings. Results—The relapse rate was 41 % during long-term treatment compared to 60 % after short-term sertraline treatment, with a median time to relapse over 8 months versus 4 months (hazard ratio 0.58; CI 0.34, 0.98; P=0.04). Subjects with severe baseline symptoms were more likely to relapse compared to the low-moderate group (hazard ratio = 2.02, CI 1.18, 3.41; P=0.01) and were more likely to relaps