Randomised trial, 2004
What medications work for PMDD when taken only during the second half of the menstrual cycle?
SSRIs including sertraline, fluoxetine, and paroxetine are the most proven treatment for PMDD when taken during the luteal phase. Symptom reduction is similar to taking them continuously, but with less medication exposure and lower costs.
What they did
Review of randomized clinical trials examining medications given only during the luteal phase, which typically lasts the last 2 weeks of the menstrual cycle, for treating PMDD.
What they found
Sertraline, fluoxetine, and paroxetine extended-release are FDA-approved for luteal phase administration for PMDD. Symptom reduction was similar with luteal phase versus continuous dosing, with good tolerance and no reported discontinuation symptoms. Progesterone has consistently failed to show efficacy in large randomized placebo-controlled trials. Buspirone and alprazolam showed only modest efficacy. Tryptophan showed significantly greater symptom reduction than placebo but has safety concerns limiting availability.
What it means for you
SSRIs are first-line medication for PMDD and work well when taken only during the luteal phase, reducing medication exposure and treatment costs. Progesterone, despite common use, does not work for PMDD. This review of clinical trial evidence provides clear guidance on proven treatments, though it is not new research.
2 weeks
typical duration of luteal phase dosing
About the study
- Original title
- Luteal phase administration of agents for the treatment of premenstrual dysphoric disorder
- Authors
- Freeman EW
- Journal
- CNS drugs
- Year
- 2004
- Study design
- Randomised trial
- What was tested
- SSRIs (sertraline, fluoxetine, paroxetine), buspirone, alprazolam, tryptophan, and progesterone given during luteal phase
- Read the paper
- doi.org/10.2165/00023210-200418070-00004
Topics
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