Fluoxetine in the treatment of premenstrual dysphoric disorder.
OBJECTIVE
To examine the role of fluoxetine in the treatment of premenstrual dysphoric disorder (PMDD).


METHODS
Search strategy included MEDLINE (1966-February 2002), Embase (1988-February 2002), HealthStar (1975-December 2000), Current Contents (1996-November 2001), and Copernic (November 2001). Search terms included fluoxetine, premenstrual dysphoric disorder, PMDD, late luteal-phase dysphoric disorder, and severe premenstrual syndrome.


METHODS
English-language human studies were selected and evaluated based on quality of evidence.


RESULTS
Eight prospective trials (3 double-blind, placebo-controlled, crossover; 3 double-blind, randomized, controlled; 2 open-label), 1 case series, and 1 meta-analysis were identified. Although 6 of the studies involved small sample sizes (n < 50), all found fluoxetine to be effective in the treatment of PMDD.


CONCLUSIONS
Despite limited data, fluoxetine 20 mg/d appears to be effective in the treatment of PMDD. However, adverse effects, particularly headaches and sexual dysfunction, are possible. Given the long half-life of fluoxetine and the short duration of PMDD symptoms per cycle, larger, well-designed clinical trials evaluating intermittent dosing for only 1 week or a few doses need to be performed.
Carr
Roxane R
RR
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Ensom
Mary H H
MH
D000293:Adolescent; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D016239:MEDLINE; D008875:Middle Aged; D011293:Premenstrual Syndrome / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors