Intermittent Paxil may ease severe PMS

NEW YORK (Reuters Health) - In women who suffer from a severe form of PMS known as premenstrual dysphoric disorder (PMDD), taking the antidepressant Paxil only when symptoms are at a peak significantly curbs irritability and improves social functioning, according to a study of Canadian women.

PMDD is a condition characterized by symptoms of severe depression, irritability and tension, which often occur during the "luteal phase" of the menstrual cycle - the part of a woman's menstrual cycle from ovulation to the start of the next period.

In their study, Dr. Meir Steiner with St. Joseph's Healthcare, Hamilton, Ontario and colleagues had a group of women suffering from PMDD rate their premenstrual symptoms each day for two consecutive menstrual cycles.

Women found to have the symptoms of irritability and/or depressed mood only in the luteal phase were randomly assigned to take paroxetine (10 or 20 milligrams) or placebo only during this time period for four additional menstrual cycles.

When compared with placebo, women treated with the higher dose of paroxetine experienced "significant improvements in the psychological symptoms associated with PMDD such as irritability, depressed mood, and tension," the investigators report.

Women treated with paroxetine 20 milligrams also experienced improvement in social and family life functioning.

These findings, the researchers note, are consistent with findings from previous studies suggesting that PMDD may be treated effectively by intermittent-only administration of paroxetine.

The findings, Steiner and colleagues add, support recently published expert guidelines for the treatment of PMDD, which state that an intermittent dosing schedule is an appropriate choice for women who wish to limit the amount of medication they take, can adhere to the on/off dosing regimen, have no mood symptoms at other times during the menstrual cycle, or are concerned about long-term side effects of antidepressant medication.

SOURCE: Journal of Clinical Psychiatry, June 2008.