Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder (PMDD) is characterized by markedly depressed mood, anxiety, affective lability, and decreased interest in daily activities during the last week of luteal phase in menstrual cycles of the last year. In 2002, Atmaca et al. conducted an 8-week, randomized, single-blind, rater-blinded, prospective- and parallel-group, flexible-dosing trial to compare the efficacy of fluoxetine with V. agnus-castus for the treatment of PMDD in 42 females. Both fluoxetine and V. agnus-castus had dose ranges from 20 to 40 mg. Outcome measures included the Penn daily symptom report, Hamilton depression rating scale, clinical global impression (CGI)-severity of illness scale, and CGI-improvement scale. Both drugs were well tolerated. No statistically significant differences between groups were found. The authors concluded that fluoxetine was more effective (a decrease of more than 50% in rating symptoms) for psychological symptoms (depression, irritability, insomnia, nervousness), whereas V. agnus-castus helped with physical symptoms (irritability, breast tenderness, swelling, cramps). Lack of placebo-control and short duration of treatment were significant limitations (14).

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