04.10.2022

Women given antidepressants for PMS may only need them for two weeks per month

Women given antidepressants to help them cope with premenstrual mood problems may need to be on the pills for only two weeks a month, a study suggests.

This intermittent dose regime was found to be just as effective in controlling symptoms as taking tablets continuously, and may help patients avoid dependency and withdrawal associated with the drugs, the researchers at the Maudsley Hospital in South London added.

The team came to their conclusions after conducting an analysis of eight trials which included 460 women with either severe premenstrual syndrome (PMS) or premenstrual dysphoric disorder, which both cause mental health problems and are linked to fluctuating hormone levels.

All had been prescribed common antidepressants known as selective serotonin reuptake inhibitors (SSRIs) to relieve symptoms.

Women given antidepressants to help them cope with premenstrual mood problems may need to be on the pills for only two weeks a month, a study suggests. (File photo)

Some took the treatment every day, while others followed what is known as a luteal phase dosing regime. This involves starting the pills on the 14th day of the monthly cycle – the luteal phase, when ovulation occurs – and taking them for two weeks, stopping on the first day of their next period.

The analysis found no significant difference in response rates and symptoms between the two groups, leading them to conclude that the intermittent dose approach was equally effective.

It is estimated that about 30 per cent of women suffer moderate to severe PMS, characterised by distressing physical, behavioural and psychological changes.

Symptoms include mood swings, depression, fatigue, irritability and aggression. Bloating, breast tenderness, clumsiness, headaches and weight gain are also common.

This intermittent dose regime was found to be just as effective in controlling symptoms as taking tablets continuously, and may help patients avoid dependency and withdrawal associated with the drugs, the researchers at the Maudsley Hospital in South London added.

Premenstrual dysphoric disorder hits between five to eight per cent of patients. While reducing stress, healthy eating and limiting alcohol can reduce symptoms, those with the worst problems are often prescribed hormonal treatments or SSRI antidepressants to help.

The researchers concluded that the intermittent dosing regime was an important option: ‘Since the SSRI is not taken continuously, there will be limited risk of withdrawal symptoms.’

GP Dr Philippa Kaye, an expert in women’s health, said: ‘I welcome any research on the impact of the menstrual cycle on mental health – it means researchers are finally taking this seriously.’

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