Response to phenelzine among depressed patients with features of hysteroid dysphoria

A 21-item questionnaire eliciting features of hysteroid dysphoria was administered to 51 depressed outpatients. Of the 47 patients who completed a 6-week double-blind study comparing the efficacy of amitriptyline and phenelzine, 14 had questionnaire scores greater than or equal to 13 (high score) and 33 had scores less than 13 (low score). Nine of nine high-score patients responded to phenelzine; only three of five high-score patients responded to amitriptyline. Low-score patients responded equally well to either drug (79% improved). These findings suggest that some depressed patients have features of hysteroid dysphoria and that these patients respond preferentially to phenelzine.