This paper is only available as a PDF. To read, Please Download here.
Abstract
Background: Because the symptoms of premenstrual dysphoric disorder (PMDD) are limited to the
luteal phase of the menstrual cycle, the potential benefit of luteal-phase dosing
has been hypothesized.
Objective: This multicenter, randomized, double-blind, placebo-controlled, parallel-group trial
evaluated the efficacy and tolerability of enteric-coated fluoxetine 90 mg given once
or twice during the luteal phase for the treatment of PMDD.
Methods: Study drug was given 14 and 7 days before expected menses during the luteal phase
of 3 menstrual cycles. After a screening period and single-blind placebo lead-in period,
eligible women were randomized to 1 of 3 treatment groups: enteric-coated fluoxetine
90 mg on both days (LPWD×2); placebo 14 days before menses and enteric-coated fluoxetine
90 mg 7 days before menses (LPWD×1); or placebo on both days (PLC). The primary efficacy
measure was change from baseline in mean luteal-phase scores on the Daily Record of
Severity of Problems (DRSP). Secondary efficacy measures included scores on the Rating
Scale for Premenstrual Tension Syndrome, Clinician-Rated (PMTS-C); the Clinical Global
Impression (CGI)—Severity scale; and the Patient Global Impression (PGI)—Improvement
scale. Quality of life was assessed using the Sheehan Disability Scale.
Results: Two hundred fifty-seven women were randomized to treatment. At the end of the study,
the LPWD×2 group had statistically significant improvements in DRSP total, DRSP mood
subtotal, DRSP social functioning subtotal, PMTS-C, CGI-Severity, PGI-Improvement,
and Sheehan Disability Scale work and family life scores compared with LPWD×1 and
PLC (each measure, P < 0.05). There was also a statistically significant improvement in the score on the
social life section of the Sheehan Disability Scale with LPWD×2 compared with PLC
(P = 0.037). Across all treatment groups, 5 patients discontinued due to nonserious
adverse events. Rates of discontinuation for any reason did not differ between the
3 treatment groups.
Conclusion: The findings of this study support the efficacy and tolerability of enteric-coated
fluoxetine 90 mg given twice during the luteal phase of the menstrual cycle for the
treatment of PMDD.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical TherapeuticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The epidemiology and social impact of premenstrual symptoms.Clin Obstet Gynecol. 1987; 30: 367-376
- Late luteal phase dysphoric disorder in young women.Am J Psychiatry. 1990; 147: 1634-1636
- The epidemiology of premenstrual symptoms in a population-based sample of 2650 urban women: Attributable risk and risk factors.J Clin Epidemiol. 1992; 45: 377-392
- Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association, Washington, DC1994 Fourth Edition.
- Is premenstrual dysphoric disorder a distinct clinical disorder?.J Women's Health. 1999; 8: 663-679
- Symptomatic improvement of premenstrual dysphoric disorder with sertraline treatment. A randomized controlled trial.JAMA. 1997; 278: 983-988
- Fluoxetine in the treatment of premenstrual dysphoria.N Engl J Med. 1995; 332: 1529-1534
- Fluoxetine in the treatment of premenstrual dysphoria.Neuropsychopharmacology. 1997; 16: 346-356
- Long-term fluoxetine treatment of late luteal phase dysphoric disorder.J Clin Psychiatry. 1994; 55: 332-335
- Full- or half-cycle treatment of severe premenstrual syndrome with a serotonergic antidepressant.J Clin Psychopharmacol. 1999; 19: 3-8
- FDA approves fluoxetine to treat premenstrual dysphoric disorder.FDA Talk Paper T00-31. July 6, 2000; (Available at: http://www.fda.gov/bbs/topics/ANSWERS/ANS01024.html. Accessed November 6, 2001)
- Intermittent fluoxetine dosing in the treatment of women with premenstrual dysphoria.Psychopharmacol Bull. 1997; 33: 771-774
- Intermittent fluoxetine dosing in premenstrual dysphoric disorder.World J Biol Psychiatry. 2001; 2 (Abstract): 204S
- A naturalistic study of paroxetine in premenstrual syndrome: Efficacy and side-effects during ten cycles of treatment.Eur Neuropsychopharmacol. 1997; 7: 201-206
- Citalopram in premenstrual dysphoria: Is intermittent treatment during luteal phases more effective than continuous medication throughout the menstrual cycle?.J Clin Psychopharmacol. 1998; 18: 390-398
- Luteal phase sertraline treatment for premenstrual dysphoric disorder. Results of a double-blind, placebo-controlled, crossover study.Arch Fam Med. 1999; 8: 328-332
- Treatment of premenstrual dysphoric disorder with sertraline during the luteal phase: A randomized, double-blind, placebo-controlled crossover trial.J Clin Psychiatry. 1998; 59: 76-80
- Intermittent luteal phase sertraline treatment of dysphoric premenstrual syndrome.J Clin Psychiatry. 1997; 58: 399-402
- The efficacy and safety of a new enteric-coated formulation of fluoxetine given once weekly during the continuation treatment of major depressive disorder.J Clin Psychiatry. 2000; 61: 851-857
- Daily rating of severity of problems form. Dept of Research Assessment and Training, NY State Psychiatric Institute, New York1990
- The measurement of premenstrual mood symptoms.J Affective Disord. 1999; 53: 269-273
- Guy W ECDEU Assessment Manual for Psychopharmacology, Revised. National Institute of Mental Health, Rockville, MD1976: 76-338
- Premenstrual tension syndrome: The development of research diagnostic criteria and new rating scales.Acta Psychiatr Scand. 1980; 62: 177-190
- Assessing psychiatric impairment in primary care with the Sheehan Disability Scale.Int J Psychiatry Med. 1997; 27: 93-105
- Design and Analysis of Experiments. John Wiley & Sons, New York1991: 50-94
- The efficacy of fluoxetine in improving physical symptoms associated with premenstrual dysphoric disorder.Br J Obstet Gynaecol. 2001; 108: 462-468
Article info
Publication history
Accepted:
January 9,
2002
Identification
Copyright
© 2002 Published by Elsevier Inc.