Hormonal Causes of Menstrual-Related Mood Disorders
Mood Disorders, Depression
About this trial
This is an observational trial for Mood Disorders focused on measuring Gonadal Steroids, GnRH Agonist, Depression, Menstrual Cycle, Menstrually Related Mood Disorder, MRMD, Healthy Volunteer, HV
Eligibility Criteria
INCLUSION CRITERIA: Women who meet the criteria for MRMD will have participated in Protocol No. 81-M-0126, The Evaluation of Women with Menstrually Regulated Mood and Behavior Disorders: Women with MRMD: History within the last two years of at least six months with menstrually-related mood or behavioral disturbances of at least moderate severity-i.e., disturbances that are distinct in appearance and associated with a notable degree of subjective distress. Symptoms should have a sudden onset and offset. age 18-50. Not pregnant and in good medical health. Medication free. No prior DSM-IV Axis I disorder. No prior history of treatment with antidepressant medications All patients participating in this protocol will have already participated in protocol No. 81-M-0126 and will have a prospectively confirmed and predictable relationship between their mood disorder and the premenstrual phase of the menstrual cycle; i.e., a 30% change in severity of symptom self rating scales, relative to the range of the scale employed, during the seven days premenstrually compared with the seven days post-menstrually in two out of three months of study. Women without MRMD: No history of menstrual-related mood or behavioral disturbances; Age 18 and 50 years; Not pregnant; Good medical health; Medication free. The absence of menstrual-related mood disorders will be prospectively confirmed during a two month period prior to the study entry when subjects will complete daily visual analogue rating scales monitoring both mood and behavior as outlined in NIMH protocol # 81-M-0126. The Structured Clinical Interview for DSM-IV will be administered to all women prior to study entry. Any patient or control with a current and any control with a past Axis I psychiatric diagnosis will be excluded from participating in this protocol. Prior to treatment, a complete physical and neurological examination will have been performed (with normal chest X-ray and EKG) and the following routine laboratory data obtained: A. Blood --Complete blood count; thyroid function tests; renal function tests, such as BUN and creatinine; electrolytes; glucose; liver function tests, B-hCG for pregnancy test. B. Urine Routine urinalysis. GnRH agonist will not be administered to any subject with significant clinical or laboratory abnormalities. Additional tests and exclusion criteria. Results of PAP smear performed not longer than 12 months prior to onset of treatment will be obtained. Subjects taking birth control pills or diuretics will be excluded from the study, as will patients taking psychotropic agents (e.g., lithium carbonate, tricyclic antidepressants). All subjects will be required to use non-hormonal forms of birth control (e.g., barrier methods) to avoid pregnancy during this study. EXCLUSION CRITERIA: The following conditions will constitute contraindications to treatment with hormonal therapy and will preclude a subject's participation in this protocol. History consistent with endometriosis. Diagnosis of ill-defined, obscure pelvic lesions, particularly undiagnosed ovarian enlargement. Hepatic disease as manifested by abnormal liver function test. History of mammary carcinoma. History of pulmonary embolism or phlebothrombosis. Undiagnosed vaginal bleeding. Porphyria. Diabetes mellitus. History of malignant melanoma. Cholecystitis or pancreatitis. Cardiovascular or renal disease. Pregnancy. Any woman meeting the Stages of Reproductive Aging Workshop Criteria (STRAW) for the perimenopause. Specifically, we will exclude any woman with an elevated plasma FSH level (> 14 IU/L) and with menstrual cycle variability of > 7 days different from their normal cycle length. Further, subjects will be warned not to become pregnant during the study and will be required to employ barrier contraceptive methods.
Sites / Locations
- National Institutes of Health Clinical Center, 9000 Rockville Pike