AUCTORES
Globalize your Research
Research Article | DOI: https://doi.org/10.31579/2578-8965/006
Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Egypt.
*Corresponding Author: Mohamed MK, Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Egypt.
Citation: Gad NM , Dawood AS , EL-Gharib MN , Mohamed MK. The Effects of Selective Serotonin Reuptake Inhibitor (sertraline) on Premenstrual Tension Syndrome. J.Obstetrics Gynecology and Reproductive Sciences, 2(1); doi. 10.31579/2578-8965/006
Copyright: © 2018 Mohamed MK. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 22 March 2018 | Accepted: 09 April 2018 | Published: 11 April 2018
Keywords: Electroencephalogram, premenstrual dysphoric disorder, premenstrual stress, premenstrual syndrome, selective serotonin reuptake inhibitors, sertraline
Background: Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS).
Aim: To examine the effect of selective serotonin reuptake inhibitor (sertraline) on electroencephalographic (EEG) patterns, and clinical manifestations in females with PMS.
Materials and Methods: This prospective observational study was conducted on 200 females. Patients will be subdivided into two groups: Group A (control): includes 80 normal females and Group B consists of 120 patients with PMS. Patients with PMS were given sertraline 50 mg/day orally, initiated 14 days before the expected onset of menses and discontinued the day menses began.
Results: We found that sertraline has no substantial effects on EEG findings, simply it relieved the clinical symptoms.
Conclusions: We recommend use of SSRIs in the treatment of PMS
Premenstrual syndrome (PMS) is determined as a combination of physical and mood disturbances that take place in the last half of a woman's menstrual cycle after ovulation which normally ends with the menstrual flow. Premenstrual dysphoric disorder (PMDD) is a serious kind of premenstrual syndrome. PMDD occurs in 3% to 8% of menstruating women [1].
Epidemiologic surveys have estimated that 75 percent of women of reproductive age, experience some symptoms attributed to the premenstrual phase of the menstrual cycle. Most adult females able to treat these symptoms through lifestyle changes and conservative therapies [2].
The American Psychiatric Association has established formal guidelines for the diagnosis of PMDD in their Diagnostic and Statistical Manual (DSM-IV). The DSM-IV diagnostic criteria of PMDD require prospective documentation of symptoms being present for at least two consecutive menstrual cycles. At least one affective and one somatic symptom must exist and symptoms are relieved within 4 days without recurrence until cycle day 13[3].
Some EEG study of adult females with PMS demonstrated that Frontal EEG asymmetry was recorded at rest and during affective picture viewing, once during lateral and once during follicular phases, in counterbalanced order [4]. El-Gharib and associated concluded that that resting luteal phase of EEG frontal asymmetry must be added to the research criteria for PMDD (DSM-IV-TR) [5].
Serotonin is a monoamine neurotransmitter. Biochemically derived from tryptophan, serotonin is primarily found in the gastrointestinal tract, blood platelets, and the cardinal nervous system. It is popularly thought to be a contributor to feelings of well-being and happiness [6].
Evidence implicates the serotonergic system, in particular in the pathogenesis of premenstrual dysphoric disorder, which is considered to be associated with symptoms such as irritability, depressed mood, and carbohydrate craving [7].
Selective serotonin reuptake inhibitors (SSRIs) are considered to increase the extracellular levels of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cells and thus increasing the measure of serotonin available to attach to the postsynaptic receptor. SSRIs are most usually used as antidepressants and anxiety disorders [8]. Numerous studies with a double-blind, randomized, confirm that SSRIs improves the quality of life of women with PMDD [9].
The hypotheses of this work is to study the effect of Selective Serotonin Reuptake Inhibitors on electroencephalographic patterns, and clinical manifestations in females with premenstrual tension syndrome.
This prospective observational cohort study was conducted on 160 women from those serving the Department of Obstetrics and Gynecology, Tanta University Hospital. Recruitment of the chess sets out in November 2015 and was finished in July 2016.
The two hundred patients included in this open area, subdivided into two groups: Group A (control): includes 80 normal females and Group B (patient): includes 120 patients with premenstrual tension syndrome.
All patients were included in the study was less than 35 years old, have a BMI between 20 and 30, having regular cycles, not using drugs (particularly ovulatory induction drugs, hormonal contraception, serotonin reuptake inhibitors and other drugs affecting CNS) during the last six months, do not cause neurological or psychiatric problems, if they owned a previous operation of the brain or spinal cord.
All patients submitted to the study were counseled thoroughly about the procedure including nature, value, and fates of the investigation and the aim of the study. After this, a written consent will be obtained and signed by the patient. We did not receive any funds, from any individual or organization. If the patient refused to complete the study, she was contracted away and replaced by another one from who are satisfying the inclusion criteria of the study. We did not classify the patients according to their religious belief or culture or race or any other inside information.
At one time women were admitted into the study, they were asked about their current phase of the cycle, by calculating backward from the starting day of the next expected period. PMDD was diagnosed by the daily symptom report [10].
Patients with PMS were given sertraline 50 mg/day orally, initiated 14 days before the expected onset of menses and discontinued the day menses began.
The Following methods were attempted for each patient:
Firstly, we prepared and clean the scalp of the patient from oil and any debris or draft, then 21 sliver-chloride electrodes were applied to the head surface and they were adherent to the scalp by using an adhesive conductive paste (10-20 paste). These electrodes were put on to the scalp according to 10-20 system. Hyperventilation and photic stimulation were applied as provocation methods during EEG recording. These signals from the surface electrodes will pass through an amplifier that converts them from parallel to digital ones which can be displayed and stored in a computer [11].
EEG was performed twice for each patient, firstly, on the 7th day of the cycle (follicular phase) and secondly on day 21 of the cycle (luteal phase).
Statistical analysis of data was performed by the IBM SPSS statistics program version 20. The value of P < 0>
The results of this study are pictured in 6 tables and 5 figures.
Table (1) shows the historic period and body mass index of the analyzed cases. The control and patient group were well seen.
Table (2) depicted the reproductive characteristics of the study group. There was a significant relation between the folk history of PMDD and the occurrence of the disease.
The main premenstrual symptoms were displayed in table 3 and figures 2 & 3, anxiety was the commonest symptoms.
Approximately 58% of patients with PMS has normal EEG findings compared with approximately 33% of cases with PMMD (tables 4-5, figure 4).
EEG findings were set at 60% with sertraline therapy (table 6 and figure 5). Figure (1) displays EEG patterns, ratio in premenstrual tension syndrome in patients during the follicular and luteal phases.
The contemporaneous study showed a substantial difference in frontal alpha asymmetry between PMS and non-PMS women and a difference between right and left hemisphere alpha activities in the luteal phase. In increase, negative affect and somatic depression were related to frontal alpha asymmetry. In that location were more severe premenstrual distress and depressive symptoms during the luteal phase than during the follicular phase, as well as more severe premenstrual distress and depressive symptoms in PMS than in non-PMS (Tables 1-3 & Figures 1-3).
In judgment with previous studies, (4) the present work examined the participants' EEG not only below the resting baseline, but also during the depressive induction and relaxation conditions. Agreeing to the Davidson's theory, frontal alpha asymmetry reveals relatively higher left than right frontal alpha activity during depressive moods in major depressive disorders.
Furthermore, Baehr et al. & Accortt et al., [12] also confirmed higher left than right frontal alpha activity under the resting baseline in a diagnostic PMDD group. The finding of this study and those of the previous studies concur that frontal alpha asymmetry significantly differed between PMDD and non-PMDD.
All the participants of the present survey are of childbearing age and experienced regular menstrual cycles. We propose that the difference found in frontal alpha asymmetry may be made by one of the pathophysiological mechanisms underlying PMS. This concurs with the findings of Davidson [13] who indicated that frontal alpha asymmetry was related to metabolic activity in the amygdala (part of the limbic system), which was connected to emotion regulation.
In the existing study, we found no substantial correlation between EEG findings and the clinical manifestation of PMS (Tables 4-6 & Figures 4-5).
Numerous treatment modalities have been proven to be efficacious in the treatments of PMS, and counseling, including psychotherapy, medications as SSRIs (selective serotonin reuptake inhibitors). SSRIs are the most effective medication available at the present for treating PMDD, hormonal therapies, including oral contraceptive pills, danazol, GnRh analogue, progesterone, progestagens and surgical removal of the ovaries [14].
Selective serotonin reuptake inhibitors (SSRIs) are currently considered the most effective pharmacologic class for the treatment of symptoms related to severe premenstrual syndrome (PMS) and it’s most intense form, premenstrual dysphoric disorder [15]. Despite the conduct of systematic reviews supporting SSRI efficacy, sources of heterogeneity between studies have not been elucidated in prior meta-analyses [16].
The SSRIs, including sertraline, represent an important advance in the pharmacotherapy of mood and other disorders. They are chemically unrelated to tricyclic, heterocyclic, and other first-generation antidepressants. SSRIs are the treatment of choice for many indications, including premenstrual dysphoric disorder, because of their efficacy, good side-effect profile, tolerability, and safety in overdose, as well as patient compliance [17].
In the current study, we gave sertraline drugs for treating cases with PMDD in a dose of 50 mg once daily starting from the 14th days till menstruation occurred, for 3 cycles. We found amelioration of symptoms in 60% of cases. These results come to an agreement with the results of several authors [18-20].
Opportunely, we did confront with any side effects to sertraline administration. This differs from the results of other authors [21, 22].
To finish, we conclude that sertraline is an effective medicament for PMDD.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
