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Premenstrual Dysphoric Syndrome Cut By Daily Fluoxetine

Daily premenstrual fluoxetine effectively treats the moods and physical and social-functioning symptoms associated with premenstrual dysphoric disorder, a multi-centre United States study has found.

Dosing at 20 mg appears to have comparable tolerability with, and better efficacy than, 10-mg doses, suggests this large research team, led by Lee S. Cohen, MD, from the Perinatal Psychiatry Clinical Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Participants in this evaluation of premenstrual fluoxetine for premenstrual dysphoric disorder were 260 women who were randomised to either 10 or 20 mg of fluoxetine or to placebo for three cycles. This was after a two-cycle screening and one-cycle single-blind placebo period.

Dosing was daily from 14 days before the next expected menses through the first full day of bleeding. The women also kept daily records of their symptoms via a computerised version of the Daily Record of Severity of Problems (DRSP).

Mean DRSP luteal scores were found to have improved significantly with the 20-mg dose but not with the 10-mg dose of premenstrual daily fluoxetine.

Although DRSP total scores were significantly improved by the first treatment cycle for both groups on fluoxetine, only fluoxetine 20 mg remained significantly superior to placebo throughout the active treatment phase of the trial.

For mood-related symptoms, both fluoxetine groups showed significant treatment advantage over placebo.

However, for physical symptoms of breast tenderness, bloating and joint/muscle pain, only premenstrual daily fluoxetine 20 mg showed significant treatment advantage over placebo.

The treatment was well tolerated, and there was no difference in the three group in terms of discontinuations of treatment due to adverse events.
Obstetrics & Gynecology Vol. 100, Iss. 3, Pp 435-444 "Premenstrual daily fluoxetine for premenstrual dysphoric disorder: a placebo-controlled, clinical trial using computerized diaries"

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