Differential Time Course Efficacy on Dysphoric & Physical Symptoms of the Intermittent Dosing of Fluoxetine in the Premenstrual Dysphoric Disorder
Abstract
Premenstrual Dysphoric disorder (PMDD) has been validated by several
epidemiological, pharmacological, biochemical and genetic studies. This
prospective open-label trial evaluated the efficacy and safety of the
intermittent treatment with 20 mg of fluoxetine taken daily during 3
consecutive menstrual cycles in the luteal phase in patients with PMDD
according to the diagnostic criteria from DSM-IV. Thirty Latinos patients
(Hispanics) with diagnosis of PMDD without depression, were recruited in
2 outpatient specialized centers in Colombia. All patients received 20 mg
of fluoxetine taken daily during 3 consecutive menstrual cycles in the
luteal phase. The primary efficacy measure was the percentage of
change from the initial score in the Calendar of Premenstrual
Experiences (COPE) after three consecutive luteal phases. The
administration of the COPE showed a significant progressive reduction in
the total score of this scale with respect to the initial point of comparison,
37.8% at the end of the first cycle of treatment (p = 0.032), 54.4% after
two cycles (p < 0.001) and 77% after three cycles (p < 0.001). A
reduction on dysphoric symptoms was observed since the first cycle of
treatment (p < 0.001). However, other mood and physical symptoms
changes were statistically significant only from the second cycle of
treatment.
This disparity in response for different symptom categories may suggest a
novel mechanism of action of SSRIs in patients with PMDD.
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