Cochrane Database Syst Rev

Are SSRIs effective for PMS and PMDD?

August 21, 2024

SSRIs probably reduce PMS and PMDD symptoms—and they are likely more effective when used continuously vs. only during the luteal phase, according to this analysis of RCTs (moderate-certainty evidence). The most common adverse events seen with SSRIs were nausea, asthenia, and somnolence.

• The review included 34 RCTs that compared the SSRIs citalopram, escitalopram fluoxetine, paroxetine, or sertraline to placebo. 68% of the studies were funded by pharmaceutical manufacturers.
• SSRIs likely reduced self‐rated PMS and PMDD symptoms, according to 12 studies (N=1,742), with standardized mean differences (SMD), −0.57, 95% CI, −0.72 to −0.42 (moderate‐certainty evidence).
• Treatment with SSRIs was likely more effective when taken continuously vs. only in the luteal phase, per moderate‐certainty evidence.
• Adverse effects linked to SSRIs: nausea (odds ratio [OR], 3.30), insomnia (OR, 1.99), sexual dysfunction or reduced libido (OR, 2.32), fatigue/sedation (OR, 1.52), dizziness/vertigo (OR, 1.96), tremor (OR, 5.38), somnolence or decreased concentration (OR, 3.26), sweating (OR, 2.17), dry mouth (OR, 2.70), asthenia/decreased energy (OR, 3.28), diarrhea (OR, 2.06), and constipation (OR, 2.39). Researchers found moderate‐certainty evidence for all adverse effects except for somnolence/decreased concentration (low‐certainty).

Source:

Jespersen C, et al. (2024, August 14). Cochrane Database Syst Rev. Selective serotonin reuptake inhibitors for premenstrual syndrome and premenstrual dysphoric disorder.
https://pubmed.ncbi.nlm.nih.gov/39140320/