---
title: Which medication works best for severe PMS: fluoxetine, propranolol, alprazolam, or pyridoxine?
description: Fluoxetine at 10 mg reduced symptoms by 65.4%, the most of any drug tested. Propranolol reduced symptoms by 58.7%, alprazolam by 55.6%, and pyridoxine by 45.3
url: https://niyora.com/research/papers/a-double-blind-trial-of-four-medications-to-treat-severe-premenstrual-syndrome-1998/
---

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- Which medication works best for severe PMS: fluoxetine, propranolol, alprazolam, or pyridoxine?

Randomised trial, 1998

# Which medication works best for severe PMS: fluoxetine, propranolol, alprazolam, or pyridoxine?

Fluoxetine at 10 mg reduced symptoms by 65.4%, the most of any drug tested. Propranolol reduced symptoms by 58.7%, alprazolam by 55.6%, and pyridoxine by 45.3%. Placebo also helped significantly, reducing symptoms by 39.4-46.1%.

 Moderate study design

120 women with severe PMS (30 per treatment group)

## What they did

120 women with severe PMS were divided into four groups of 30. Each woman received three months of placebo, then three months of one of four active drugs: pyridoxine (300 mg/day), alprazolam (0.75 mg/day), fluoxetine (10 mg/day), or propranolol (20-40 mg/day depending on whether she was menstruating).

## What they found

Symptom reduction was: fluoxetine 65.4%, propranolol 58.7%, alprazolam 55.6%, pyridoxine 45.3%, and placebo 39.4-46.1%.

## What it means for you

Fluoxetine was the most effective drug tested for severe PMS, but all treatments including placebo reduced symptoms. The strong placebo response (39-46% improvement) highlights how much a woman's expectations and belief in a treatment matter for PMS symptom relief.

120

women total

65.4

percent symptom reduction (fluoxetine)

39-46

percent symptom reduction (placebo)

## About the study

Original title A double-blind trial of four medications to treat severe premenstrual syndrome Authors Diegoli MS, da Fonseca AM, Diegoli CA et al. Journal International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics Year 1998 Study design Randomised trial Participants 30 What was tested Pyridoxine 300 mg/day vs alprazolam 0.75 mg/day vs fluoxetine 10 mg/day vs propranolol 20-40 mg/day vs placebo Read the paper [doi.org/10.1016/s0020-7292(98)00035-6](https://doi.org/10.1016/s0020-7292(98)00035-6)

## Topics

[Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)[Vitamin B6](https://niyora.com/research/topics/treatment-vitamin-b6/)[Anxiolytics and other psychotropics](https://niyora.com/research/topics/treatment-anxiolytics/)

Research tells you what helps on average. Niyora helps on the day it hits.

Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor.

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