Magazine article Clinical Psychiatry News

Luteal-Phase Antidepressants an Option in PMS, PMDD: Expert Analysis from a Conference on Women's Health

Magazine article Clinical Psychiatry News

Luteal-Phase Antidepressants an Option in PMS, PMDD: Expert Analysis from a Conference on Women's Health

Article excerpt

SAN FRANCISCO--Selective serotonin reuptake inhibitor antidepressants can alleviate symptoms of premenstrual syndrome or premenstrual dysphoric disorder, but are far from first-line therapies for either disorder, according to Dr. Ellen Haller.

The first steps in treating PMS and PMDD are basic wellness strategies such as a healthy diet, smoking cessation, exercise, adequate sleep, and stress management, Dr. Haller said the conference, sponsored by the University of Cslifornia, San Francisco.

Calcium supplementation also has been shown to reduce total emotional and physical symptom scores by 48% in women with PMS compared with a 30% reduction from placebo in a multicenter, randomized placebo-controlled study of 497 patients. That study used 600 mg, twice daily, of calcium carbonate or placebo for three menstrual cycles, said Dr. Haller, professor of clinical psychiatry at the university.

The results of that study (Am. J. Obstet. Gynecol. 1998;179:444-52) have not been replicated, she added.

If wellness treatments and calcium supplementation don't work, the next step for treating women with PMS may be an SSM. A Cochrane review of 31 randomized controlled trials found that SSRIs are more effective than placebo in treating PMS (Cochrane Database Syst. …

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