Paroxetine Treats Premenstrual Mood Disorder

NEW YORK (Reuters Health) - Intermittent dosing of controlled release paroxetine (Paxil-CR) is successful for the treatment of premenstrual dysphoric disorder (PMDD), a condition characterized by symptoms of severe depression, irritability and tension, which occurs before menstruation, researchers report.

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

The symptoms of PMDD usually begin about a week before menstruation and last until a few days after the menstrual flow begins, Steiner, of McMaster University, Hamilton, Ontario, and colleagues report in the American Journal of Obstetrics and Gynecology.

Paroxetine controlled release administered throughout the menstrual cycle has already been shown to be effective against PMDD, the researchers point out. They investigated whether this might be the case when using intermittent dosing.

The team randomly assigned 373 patients with the disorder to three treatment cycles with 12.5 mg or 25 mg of paroxetine or placebo during the luteal phase of their menstrual cycle - two weeks after ovulation.

Mood scores, premenstrual tension scores and other measures including patient assessment of PMDD symptoms showed improvement over placebo in the paroxetine treatment groups. Scoring of impairment of work and family life also showed significant enhancement. Overall, improvements were similar to those seen in studies in which paroxetine was administered continuously throughout the menstrual period.

The researchers conclude that luteal phase treatment with either dose of the drug "is effective and generally well tolerated."

SOURCE: American Journal of Obstetrics and Gynecology, August 2005.