title: Rapid response to fluoxetine in women with premenstrual dysphoric disorder.
abstract: BACKGROUND
  Selective serotonin reuptake inhibitors (SRIs) relieve irritability within days in women with premenstrual dysphoric disorder (PMDD); however, the effects on other affective symptoms in PMDD remain to be demonstrated.
  
  
  METHODS
  We performed hourly ratings in women with PMDD to test the specificity of the therapeutic effects of SRIs and to determine whether the kinetics of these effects differ from those of the symptom offset accompanying menses. Twelve women with PMDD received fluoxetine (20 mg daily) during the luteal phase of the menstrual cycle. Twelve other women with PMDD received no treatment. Outcome measures included a visual analogue scale completed hourly before and after either the start of SRIs or at menses-onset in the untreated women and the premenstrual tension syndrome (PMTS) scale completed daily. Data were analyzed by ANOVA-R.
  
  
  RESULTS
  Hourly VAS scores significantly improved after SRI in irritability as well as sadness, anxiety, and mood swings. Compared with the symptomatic pretreatment baseline, PMTS scores significantly improved on the second day after the start of SRI (p < .01). An identical time course of symptom improvement occurred after both SRI and menses-onset.
  
  
  CONCLUSIONS
  These data document that the rapid response to SRI was not limited to irritability. The similar kinetics in the remission of PMDD after SRIs and after menses-onset suggest both a phenotype reflecting the relative capacity to rapidly change affective state, and a possible therapeutic mechanism by which SRIs recruit this endogenous capacity to change state, normally expressed around menses-onset in women with PMDD.
authors.affiliation: Behavioral Endocrinology Branch, National Institute of Mental Health, National Institutes of Health, Department of Health & Human Services, Bethesda, Maryland, USA.
authors.forename: Emma M
authors.initials: EM
authors.lastname: Steinberg
authors.forename: Graca M P
authors.initials: GM
authors.lastname: Cardoso
authors.forename: Pedro E
authors.initials: PE
authors.lastname: Martinez
authors.forename: David R
authors.initials: DR
authors.lastname: Rubinow
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Schmidt
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D004334:Drug Administration Schedule; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006240:Happiness; D006801:Humans; D007508:Irritable Mood / Q000187:drug effects; D008183:Luteal Phase / Q000187:drug effects / Q000523:psychology; D011293:Premenstrual Syndrome / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors