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Paroxetine (Paxil) – Now for Premenstrual Syndrome

Intermittent dosing with controlled-release paroxetine (Paxil-CR) has been shown effective in treating premenstrual syndrome. Also known as premenstrual dysphoric disorder or “PMDD”, the condition is characterized by a variety of symptoms, including severe depression, tensions and irritability before menstruation.

The recent study by Meir Steiner, MD, of McMaster University, Hamilton, Ontario, and colleagues, was published in the American Journal of Obstetrics and Gynecology and reported by Reuters on 31 August 2005.

"Both physicians and patients rate the treatment as being effective against the symptoms of PMDD. It also reduces the functional impairment that these patients experience," primary investigator Steiner told Reuters Health.

Taking controlled-release paroxetine throughout the menstrual cycle has been shown effective in controlling PMDD symptoms. This study examined whether intermittent dosing was also effective.

Study Protocol

The researchers randomly assigned 373 patients with PMDD to receive three treatment cycles of paroxetine (12.5 mg or 25 mg) or placebo during the luteal phase of their menstrual cycle, two weeks after ovulation.

PMDD symptoms normally start one week before menstruation and may last until a few days after menstruation starts, according to Steiner and colleagues.

Assessment methods included mood scores, premenstrual tension scores and other measures, including patient-assessment of PMDD symptoms.

Results & Conclusion

Results showed that paroxetine-treated patients showed improvement over patients receiving placebo. Also, scores in the area of impairment of work and family life showed significant enhancement.

Overall, improvements were similar to those observed in previous studies in which study subjects received paroxetine continuously throughout the menstrual period.

Steiner et al. concluded that luteal-phase treatment with paroxetine – either continuously or with intermittent dosing – "is effective and generally well tolerated."

Luteal phase dosing with paroxetine controlled release (CR) in the treatment of premenstrual dysphoric disorder. M Steiner et al., American Journal of Obstetrics & Gynecology, volume 193(2), pages 352-360, August 2005.
Paroxetine treats premenstrual mood disorder, Reuters, 31 August 2005.

Posted: September 2005