Which symptoms a woman has may determine whether or not antidepressants may help her, according to a recent study published in the journal Obstetrics & Gynecology.

Symptoms of premenstrual syndrome (PMS) can include bloating, breast tenderness, headaches and emotional stress that occur prior to the menstrual period. In some cases, the symptoms are severe enough that antidepressants known as selective serotonin reuptake inhibitors (SSRIs) are prescribed to help alleviate the symptoms.

In the study of nearly 450 women using Zoloft to treat PMS symptoms, almost half – about 40 percent -- did not see improvement of their symptoms with the drug. Those with multiple physical and psychological symptoms were more likely to see an improvement, whereas those with primarily physical symptoms got little help.

“If the symptoms are predominately physical, it seems unlikely that an SSRI will help,” said study leader Ellen W. Freeman, a research professor of obstetrics and gynecology at the University of Pennsylvania in Philadelphia.

In addition, SSRIs come with their own side effects, including headaches, nausea, sleep and libido problems.