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Randomised trial, 2007

Does paroxetine work better if taken daily or just during your luteal phase for PMDD?

Daily paroxetine had an 85% response rate and was most effective overall, while luteal-phase-only paroxetine worked equally well for irritability and mood swings but was weaker for depression and physical symptoms. This well-designed study provides reliable results.

Strong study design 55-56 women per group (mean age 37 years) with PMDD

What they did

55-56 women per group were randomly assigned to take paroxetine continuously, paroxetine only during the luteal phase, or placebo for three menstrual cycles. Their premenstrual symptoms were measured regularly.

What they found

Continuous paroxetine had an 85% response rate. Irritability showed the strongest improvement with an effect size of 1.4, while lack of energy showed the weakest improvement with an effect size of 0.5. Intermittent paroxetine worked equally well for irritability, mood swings, and affect lability, but was somewhat weaker for depressed mood and physical symptoms. Both active treatments beat placebo.

What it means for you

Paroxetine is effective for PMDD. Women whose main symptoms are irritability and mood instability can consider luteal-phase-only dosing as a practical option. Women with depression or physical symptoms may benefit more from daily dosing. This was a high-quality study with a large sample and placebo control, so the results are reliable.

85%

Response rate with continuous paroxetine

55-56

Women per treatment group

1.4

Effect size for irritability (strongest)

About the study

Original title
Placebo-controlled trial comparing intermittent and continuous paroxetine in premenstrual dysphoric disorder
Authors
Landén M, Nissbrandt H, Allgulander C et al.
Journal
Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology
Year
2007
Study design
Randomised trial
Participants
56
What was tested
Paroxetine 20 mg continuously, during luteal phase, or placebo

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