--- title: Is taking SSRIs only during the luteal phase as effective as taking them every day for PMS? description: Yes. Taking SSRIs only during the luteal phase works about as well as taking them daily. Intermittent dosing may be preferable because it uses less medication url: https://niyora.com/research/papers/intermittent-selective-serotonin-reuptake-inhibitors-for-premenstrual-syndromes-2023/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Is taking SSRIs only during the luteal phase as effective as taking them every day for PMS? Systematic review, 2023 # Is taking SSRIs only during the luteal phase as effective as taking them every day for PMS? Yes. Taking SSRIs only during the luteal phase works about as well as taking them daily. Intermittent dosing may be preferable because it uses less medication. Moderate study design People with premenstrual syndromes (460 total). ## What they did Researchers searched for randomized trials comparing intermittent (luteal-phase only) SSRI dosing to continuous (daily) dosing for premenstrual conditions. They found 8 eligible trials and combined results from 460 total participants. ## What they found There were no statistically significant differences between intermittent and continuous dosing in response rates, dropout rates, or symptom improvement. Response rates and symptom changes were similar between the two approaches. ## What it means for you Both dosing schedules appear equally effective. Intermittent dosing may be preferable because you take less medication overall, which could reduce withdrawal effects when stopping. However, most studies had moderate or high risk of bias, so better-designed studies are needed. 8 Randomized trials included 460 Total participants 1.0 Odds ratio for response rates ## About the study Original title Intermittent selective serotonin reuptake inhibitors for premenstrual syndromes: A systematic review and meta-analysis of randomised trials Authors Reilly TJ, Wallman P, Clark I et al. Journal Journal of psychopharmacology (Oxford, England) Year 2023 Study design Systematic review What was tested Intermittent SSRI dosing versus continuous SSRI dosing. Open access Yes Read the paper [doi.org/10.1177/02698811221099645](https://doi.org/10.1177/02698811221099645) Original abstract Background: Intermittent (luteal phase) dosing of selective serotonin reuptake inhibitors is one treatment strategy for premenstrual syndromes such as premenstrual dysphoric disorder. This avoids the risk of the antidepressant withdrawal syndrome associated with long-term continuous dosing. Aims: To compare intermittent dosing to continuous dosing in terms of efficacy and acceptability. Methods: We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, PubMed and CINAHL for randomised trials of intermittent compared with continuous dosing of selective serotonin reuptake inhibitors in premenstrual syndromes. We extracted response rates, dropout rates and changes in symptom scores. We used random effects meta-analyses to pool study-level data and calculated odds ratio for dichotomous data and standardised mean difference for continuous data. Risk of bias was assessed using the Cochrane risk-of-bias tool. The study was registered with PROSPERO (CRD42020224176). Results: A total of 1841 references were identified, with eight studies being eligible for analysis, consisting of a total of 460 participants. All included studies provided response rates, six provided dropout rates and five provided symptom scores. There was no statistically significant differences between intermittent and continuous dosing in terms of response rate (odds ratio: 1.0, 95% confidence interval (CI): 0.23-4.31, I 2 = 71%), dropout rate (odds ratio 1.26, 95% CI: 0.39-4.09, I 2 = 33%) or symptom change (standardised mean difference: 0.04, 95% CI: -0.27 to 0.35, I 2 = 39%). All studies had a moderate or high risk of bias. Conclusion: Since intermittent dosing avoids the potential for withdrawal symptoms, it should be considered more commonly in this patient population. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/) 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, 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? Review, 2022 What causes severe PMS and what treatments work? Ask AI about this page Copy prompt ChatGPT ↗ Claude ↗ Perplexity ↗ Google AI Mode ↗ Grok ↗