Citalopram in Premenstrual Dysphoria

Wikander, Ida; Sundblad, Charlotta; Andersch, Björn; Dagnell, Inger; Zylberstein, Dimitri; Bengtsson, Finn; Eriksson, Elias

doi:10.1097/00004714-199810000-00007

Cited by 150 publications

(13 citation statements)

References 22 publications

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“…Maximal improvement was noted in the first treatment cycle for irritability symptom, indicating the rapid onset of irritability-relieving effects of duloxetine. These evidences are similar to previous literature reports that the onset of serotonergic antidepressant is more rapid in PMDD treatment than in treatment of other mood disorders (Cohen et al 2002 ;Freeman et al , 2001Steiner et al 1995 ;Wikander et al 1998 ;Yonkers et al 1997).…”

Section: Discussionsupporting

confidence: 92%

Duloxetine treatment for women with premenstrual dysphoric disorder: a single-blind trial

Ramos¹,

Hara²,

Rocha³

2009

Int. J. Neuropsychopharm.

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Premenstrual dysphoric disorder (PMDD) affects 3-8% of women of reproductive age and is characterized by severe mood symptoms that cause important functional impairment. Serotonergic antidepressants appear to be an effective treatment for this disorder. The purpose of this study was to collect evidence on the efficacy and tolerability of duloxetine, a dual reuptake inhibitor of serotonin and norepinephrine, in the treatment of PMDD. We conducted a pilot, single-blind, non-controlled, fixed-dose trial. After two cycles for diagnosis confirmation, including a single-blind placebo cycle, 20 women with PMDD were treated continuously for three menstrual cycles with 60 mg/d duloxetine. The primary measure of the efficacy of treatment with duloxetine was the significant reduction in premenstrual symptoms demonstrated by the comparison between the mean Daily Record of Severity of Problems (DRSP) scores at baseline to endpoint (p=0.0002). Statistically significant symptom reduction was observed in the first treatment cycle and throughout all the treatment phase. Clinical response, defined as a reduction 50% of baseline premenstrual symptoms, occurred in 65% of subjects (intention-to-treat population). Significant improvements were demonstrated by secondary measures, including reduction in self-rated functional impairment (p=0.01) and improvement in quality of life (p=0.04). The main side-effects associated with duloxetine were dry mouth, nausea, drowsiness, insomnia, decreased appetite, decreased libido, and sweating. Duloxetine was effective and generally well tolerated in the treatment of PMDD. Further large-scale, double-blind, placebo-controlled studies are needed to evaluate duloxetine as an additional treatment strategy for the management of PMDD.

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Section: Discussionsupporting

confidence: 92%

Duloxetine treatment for women with premenstrual dysphoric disorder: a single-blind trial

Ramos¹,

Hara²,

Rocha³

2009

Int. J. Neuropsychopharm.

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“…Importantly, women in their reproductive years show a better therapeutic response to SSRIs, whereas postmenopausal women show a lower response to SSRIs [64]. Furthermore, the administration of SSRIs to improve symptoms of premenstrual syndrome can be shortened if women receive treatment when estradiol levels are high [11, 65]. Hence, because of their common effect in attenuating the sensitivity of 5-HT 1A receptors, a combination of SSRIs with estradiol could act synergistically to treat mood disorders.…”

Section: Discussionmentioning

confidence: 99%

“…The underlying cause of these mood disorders may involve changes in serotonergic function due to changes in ovarian hormone levels. Although treatment of some of these disorders has included estradiol replacement therapy, antidepressants such as fluoxetine (Prozac ® ) or paroxetine (Paxil ® ) have been more successful [3, 9, 10, 11]. …”

Section: Introductionmentioning

confidence: 99%

Ovariectomy-Induced Increases in Hypothalamic Serotonin-1A Receptor Function in Rats Are Prevented by Estradiol

Raap¹,

DonCarlos

García³

et al. 2002

Neuroendocrinology

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The present study investigated the effects of long-term estradiol withdrawal (ovariectomy) on hypothalamic serotonin-1A (5-HT_1A) receptor signaling. Changes in neuroendocrine responses to the 5-HT_1A agonist 8-OH-DPAT and levels of G_z protein in the hypothalamus were used to examine 5-HT_1A receptor signaling. Five days following ovariectomy, rats received daily injections of either 2 µg of β-estradiol 3-benzoate or vehicle (subcutaneously) for 2, 4 or 14 days. Twenty-four hours after the last injection, and 15 min prior to sacrifice, rats were injected with (±)8-OH-DPAT (50 µg/kg, s.c.) or saline. Estradiol treatment did not alter basal corticotropin (ACTH) or oxytocin levels. Injection of (±)8-OH-DPAT produced significant increases in plasma ACTH and oxytocin levels. In the vehicle-treated rats, hormone responses to 8-OH-DPAT were enhanced in rats that received injections for 14 days compared with rats that received injections for either 2 or 4 days. Estradiol treatment for 4 or 14 days blunted this enhanced ACTH response to 8-OH-DPAT, whereas the oxytocin response to 8-OH-DPAT was only blunted after 14 daily injections of β-estradiol 3-benzoate. The treatment with β-estradiol 3-benzoate (2 µg/rat) did not reduce membrane-associated G_z protein levels in the paraventricular nucleus of the hypothalamus. Hence, the inhibitory influence of a low dose of β-estradiol 3-benzoate on 5-HT_1A receptor signaling in the hypothalamus is not accompanied by a change in the levels of G_z protein in the paraventricular hypothalamic nucleus. Results from the present study indicate a supersensitivity of 5-HT_1A receptors after withdrawal of estradiol and suggest that estradiol suppresses 5-HT_1A receptor signaling.

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“…208 Both mood and physical symptoms remitted with SRI use. 10,209–214 The serotonergric tricyclic antidepressant clomipramine, 215,216 the selective SRIs (e.g., citalopram, 217,218 escitalopram, 219 fluoxetine, 210–212,220–224 sertraline, 225,226 and paroxetine), 209,227–230 and the serotonin and noradrenaline reuptake inhibitor venlafaxine 231,232 all lessen both mood and somatic symptoms, while improving quality of life and social functioning. 12,221,227,233 For PMS patients with severe mood symptoms, SRIs offer a strong first-treatment option.…”

Section: Treatmentmentioning

confidence: 99%

Update on Research and Treatment of Premenstrual Dysphoric Disorder

Cunningham

Yonkers

O’Brien

et al. 2009

Harvard Review of Psychiatry

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154

114

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Many women in their reproductive years experience some mood, behavioral. or physical symptoms in the week prior to menses. Variability exists in the level of symptom burden in that some women experience mild symptoms, whereas a small minority experience severe and debilitating symptoms. For an estimated 5%–8% of premenopausal women, work or social functioning are affected by severe premenstrual syndrome. Many women in this group meet diagnostic criteria for premenstrual dysphoric disorder (PMDD). Among women who suffer from PMDD, mood and behavioral symptoms such as irritability, depressed mood, tension, and labile mood dominate. Somatic complaints, including breast tenderness and bloating, also can prove disruptive to women's overall functioning and quality of life. Recent evidence suggests that individual sensitivity to cyclical variations in levels of gonadal hormones may predispose certain women to experience these mood, behavioral, and somatic symptoms. Treatments include: antidepressants of the serotonin reuptake inhibitor class, taken intermittently or throughout the menstrual cycle; medications that suppress ovarian cyclicity; and newer oral contraceptives with novel progestins. (Harv Rev Psychiatry 2009;17:120–137.)

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Citalopram in Premenstrual Dysphoria

Cited by 150 publications

References 22 publications

Duloxetine treatment for women with premenstrual dysphoric disorder: a single-blind trial

Duloxetine treatment for women with premenstrual dysphoric disorder: a single-blind trial

Ovariectomy-Induced Increases in Hypothalamic Serotonin-1A Receptor Function in Rats Are Prevented by Estradiol

Update on Research and Treatment of Premenstrual Dysphoric Disorder

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