Systematic review, 2000
Do SSRIs work for severe premenstrual syndrome?
Yes, strongly. SSRIs are about 7 times more likely to improve symptoms than placebo. However, side effects cause about 2.5 times more people to stop taking them.
What they did
Meta-analysis combining 15 randomised placebo-controlled trials of SSRIs for severe PMS. The primary analysis included 904 women (570 given active SSRI treatment, 435 given placebo, including 101 in crossover trials).
What they found
SSRIs were very effective. The odds ratio was 6.91, meaning SSRIs were about 7 times more likely to improve overall symptoms than placebo. They worked equally well for physical symptoms and behavioural symptoms. Continuous daily dosing worked as well as intermittent dosing. Withdrawal due to side effects was 2.5 times more likely in the SSRI group than the placebo group. There was no significant difference between company-funded and independently funded trials.
What it means for you
SSRIs are a proven first-line treatment for severe PMS. At low doses the side effects are generally acceptable. This combines data from many good-quality trials, making the evidence very strong.
904
Women in primary analysis
6.91
Odds ratio (SSRIs 7 times better than placebo)
2.5
Times more likely to withdraw due to side effects
About the study
- Original title
- Efficacy of selective serotonin-reuptake inhibitors in premenstrual syndrome: a systematic review
- Authors
- Dimmock PW, Wyatt KM, Jones PW et al.
- Journal
- Lancet (London, England)
- Year
- 2000
- Study design
- Systematic review
- What was tested
- SSRIs (selective serotonin reuptake inhibitors) vs placebo
- Read the paper
- doi.org/10.1016/s0140-6736(00)02754-9
Topics
Related studies
Review, 2026
How well do SSRIs treat PMS?
Systematic review, 2024
What are the best treatments for PMDD and PMS?
Review, 2024
What are the most effective treatments for PMDD?
Systematic review, 2024
Do SSRI antidepressants help treat PMS and PMDD?
Randomised trial, 2023
Does taking sertraline when PMDD symptoms start improve how well women function?
Guideline, 2023
How are GnRH agonists used to treat PMDD that doesn't respond to standard medications?