Randomised trial, 2002
Are SSRIs the best treatment for PMDD?
Yes, SSRIs are very effective for PMDD. All studies of fluoxetine, sertraline, paroxetine, and citalopram reported positive results, making SSRIs the emerging gold standard treatment.
What they did
Review of 20 randomized controlled trials of SSRIs for PMDD. Twelve trials used continuous dosing throughout the cycle, while 8 trials used dosing only during the luteal phase before menses. The drugs tested included fluoxetine, sertraline, paroxetine, citalopram, and fluvoxamine.
What they found
All treatment studies on fluoxetine, sertraline, paroxetine, and citalopram reported positive efficacy for PMDD. Most side effects were mild and transient (anxiety, dizziness, insomnia, sedation, nausea, headache). Sexual dysfunction and weight gain can be problematic long-term adverse effects, but these have not been systematically evaluated with long-term SSRI use in women with PMDD.
What it means for you
SSRIs are well-proven and considered the gold standard for PMDD, with rapid onset of action. However, long-term side effects such as sexual dysfunction and weight gain need more systematic study. The mechanism in PMDD appears different from their use in depression.
20
Randomized controlled trials reviewed
12
Trials with continuous SSRI dosing
8
Trials with luteal phase dosing
About the study
- Original title
- Selective serotonin reuptake inhibitors for premenstrual dysphoric disorder: the emerging gold standard?
- Authors
- Pearlstein T
- Journal
- Drugs
- Year
- 2002
- Study design
- Randomised trial
- What was tested
- SSRIs: fluoxetine, sertraline, paroxetine, citalopram, fluvoxamine
- Read the paper
- doi.org/10.2165/00003495-200262130-00004
Topics
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