Fluoxetine in the treatment of premenstrual dysphoria.
We performed a double-blind, placebo-controlled, crossover trial of fluoxetine in 17 women with prospectively confirmed PMS who also met criteria for premenstrual dysphoric disorder (PMDD). A subset of 10 women with PMDD and an additional 10 controls participated in a single-dose m-chlorophenylpiperazine (m-CPP) challenge during the follicular and luteal phases of the menstrual cycle. We evaluated the ability of the acute behavioral response to luteal phase m-CPP administration to predict therapeutic response to fluoxetine. compared with baseline, fluoxetine, but not placebo, treatment significantly improved both emotional and physical symptoms. We identified 11 (65%) fluoxetine responders who no longer met diagnostic criteria for PMDD during fluoxetine but remained symptomatic during placebo treatment. In addition, acute symptomatic improvement also occurred following m-CPP administration in 7 of 10 women with PMDD. The small number of m-CPP nonresponders did not respond to fluoxetine either. Our findings confirm that fluoxetine is an effective treatment of PMDD.
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T P
TP
National Institute of Mental Health, Bethesda, Maryland 20892-1276, USA.
Schmidt
P J
PJ
Danaceau
M A
MA
Tobin
M B
MB
Rosenstein
D L
DL
Murphy
D L
DL
Rubinow
D R
DR
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D010555:Personality Inventory; D010879:Piperazines / Q000494:pharmacology; D011293:Premenstrual Syndrome / Q000188:drug therapy*; D011446:Prospective Studies; D012647:Self-Assessment; D017366:Serotonin Receptor Agonists / Q000494:pharmacology
D018687:Antidepressive Agents, Second-Generation; D010879:Piperazines; D017366:Serotonin Receptor Agonists; D005473:Fluoxetine; C015068:1-(3-chlorophenyl)piperazine