Luteal Phase Fluoxetine Dosing Improves PMDD

OB/GYN News, Oct 1, 2001 by Winnie Anne Imperio

NEW ORLEANS - Luteal phase dosing with fluoxetine was effective in treating mood and physical symptoms of premenstrual dysphoric disorder, according to several poster presentations at the annual meeting of the American Psychiatric Association.

In a randomized, placebo-controlled study of 260 women, luteal phase dosing with fluoxetine (Prozac, Serafem) 20 mg daily significantly improved total scores and subscale scores for mood symptoms, physical symptoms, and social functioning on the Daily Record of Severity of Problems (DRSP), compared with placebo, said-Dr. Cherri Miner of Lilly Research Laboratories, Indianapolis. Luteal phase dosing with fluoxetine 10 mg daily significantly improved mood and social functioning sub-scale scores, compared with placebo.

Following a two-cycle screening period and a one-cycle single-blind placebo period, the subjects received luteal phase dosing with fluoxetine 10 mg or 20 mg daily or placebo for three cycles. Subjects used the DRSP to record PMDD symptoms daily.

Fluoxetine 20 mg daily improved the overall physical symptom score and individual scores for breast tenderness, bloating, and joint and muscle pain, compared with placebo and fluoxetine 10 mg daily.

The improvements associated with fluoxetine 20 mg were detected by the first treatment cycle, she noted. The fact that both doses of fluoxetine were associated with significant improvement in mood symptoms and social functioning, but not physical symptoms, indicates that patients are actually experiencing improvement in physical symptoms and are not just perceiving their physical symptoms differently because their mood and functioning symptoms have been alleviated.

Following the three-cycle treatment period, the subjects underwent another one-cycle placebo period. During this period, relapse of symptoms occurred.

Symptom scores did not return to baseline, but were similar to those of the placebo group. It is possible that the scores would have returned to pretreatment baseline had the women been assessed beyond the first cycle after drug discontinuation, the investigators said.