--- title: Does progesterone or the anti-anxiety drug alprazolam work better for severe PMS? description: Alprazolam was significantly better than both progesterone and placebo, with 37% of women experiencing a 50% reduction in symptoms. Progesterone was no better url: https://niyora.com/research/papers/a-double-blind-trial-of-oral-progesterone-alprazolam-and-placebo-in-treatment-of-1995/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Does progesterone or the anti-anxiety drug alprazolam work better for severe PMS? Randomised trial, 1995 # Does progesterone or the anti-anxiety drug alprazolam work better for severe PMS? Alprazolam was significantly better than both progesterone and placebo, with 37% of women experiencing a 50% reduction in symptoms. Progesterone was no better than placebo. Strong study design 170 women with severe PMS (from 444 screened, 185 met criteria) ## What they did This was a randomized trial with 170 women who had severe PMS. Women took either 300 mg of oral progesterone four times daily, 0.25 mg of alprazolam four times daily, or placebo from day 18 through day 2 of the next cycle, for 3 months. Women were randomly assigned to brief or extended clinical visits. ## What they found Alprazolam was significantly better than placebo or progesterone for all measures tested. Thirty-seven percent of the alprazolam group experienced a 50% reduction in symptoms, with no significant withdrawal symptoms. Progesterone was no better than placebo. Brief visits were as effective as extended visits. ## What it means for you Alprazolam effectively reduces severe PMS symptoms when used only during the luteal phase. Progesterone supplementation does not work. More clinical contact does not improve outcomes. This is a large, well-designed study, but alprazolam carries risks of dependency. 170 Number of women who completed treatment 37% Percentage with 50% symptom reduction on alprazolam 3 months Treatment duration ## About the study Original title A double-blind trial of oral progesterone, alprazolam, and placebo in treatment of severe premenstrual syndrome Authors Freeman EW, Rickels K, Sondheimer SJ et al. Journal JAMA Year 1995 Study design Randomised trial What was tested 300 mg four times daily oral progesterone, 0.25 mg four times daily alprazolam, or placebo Read the paper [doi.org/10.1001/jama.1995.03530010065036](https://doi.org/10.1001/jama.1995.03530010065036) ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Estradiol, progesterone and hormone therapy](https://niyora.com/research/topics/treatment-hormone-therapy/)[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. ## Related studies Systematic review, 2007 What treatments work for premenstrual syndrome? Review, 2006 How do brain hormones affect PMDD and mood problems during the menstrual cycle? Review, 2003 What role do hormones play in PMS and how should we treat it? Randomised trial, 1999 Does the drop in progesterone or stress during the menstrual cycle cause chocolate and sweets cravings? Survey study, 1989 What does research say about what causes PMS and what treatments work? Survey study, 2014 Does allopregnanolone, a progesterone metabolite, cause mood problems in PMDD? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗