Article

Fluoxetine’s spectrum of action in premenstrual syndrome

University of Otago, Taieri, Otago, New Zealand
International Clinical Psychopharmacology (Impact Factor: 3.1). 02/1993; 8(2):95-102. DOI: 10.1097/00004850-199300820-00003
Source: PubMed

ABSTRACT This study extends our previous report of the efficacy and tolerability of fluoxetine in severe premenstrual syndrome (PMS), describes which aspects of the disorder are responsive to such treatment, and assesses the relationship between steady-state drug level and clinical outcome. Twenty-one women with documented PMS satisfied criteria for late luteal phase dysphoric disorder (DSM-III-R) and accepted the offer of a double-blind, randomized crossover trial of fluoxetine hydrochloride 20 mg/day vs placebo. Symptom severity was measured with daily self-rating, monthly premenstrual assessment forms and psychiatric interviews after 3 months each of baseline, placebo and fluoxetine treatment. Compared with an inconsistent placebo response, fluoxetine produced marked improvement in 15 of 16 women completing the trial, eight showing virtually complete remission of PMS symptoms. Fluoxetine's efficacy extended over a range of affective, physical and behavioural symptoms; its superiority obtained whether it preceded or followed placebo. Three women withdrew due to adverse effects of fluoxetine, and 10 of 16 completing the trial reported at least one adverse effect of this agent. Compared with placebo, fluoxetine produced more (but usually transient) insomnia, sweating, gastrointestinal and menstrual disturbance. Plasma levels of fluoxetine and its active metabolite were not reliably associated with efficacy nor with side effects. Serotonergic agents appear to have considerable promise in treating a range of symptoms in women with severe PMS.

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    • "In at least two of these cases, hyperprolactinemia was also reported [33] [34] [35]. Moreover, clinical trials showed menstrual cycle changes in women who were using FLX [36] [37]. Studies in men have suggested that SSRIs may damage normal sperm DNA integrity and thereby adversely affect fertility [38]. "
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    ABSTRACT: Recent years have seen an increase in the use of antidepressant drugs, especially fluoxetine (FLX), in sensitive populations, such as pregnant and lactating women. Although some evidence suggests a possible endocrine action of FLX, no specific studies have been performed to investigate this hypothesis. In the present study, we investigated the possible (anti)androgenic and (anti)estrogenic actions of FLX using Hershberger, uterotrophic (0.4, 1.7, and 17 mg/kg), and reporter gene (7.6–129 μM) assays. In the Hershberger assay, no differences were observed in androgen-dependent organ weights. However, the uterotrophic and gene reporter assays indicated a possible estrogenic action of FLX. Uterine weight increased in the 1.7 and 17 mg/kg/day groups in the 3-day uterotrophic assay in immature rats. Additionally, noncytotoxic concentrations of FLX induced estrogenic responses and increased the estrogenic response of estradiol in MCF-7 breast cancer cells transfected with luciferase.
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    • "In at least two of these cases, hyperprolactinemia was also reported [33] [34] [35]. Moreover, clinical trials showed menstrual cycle changes in women who were using FLX [36] [37]. Studies in men have suggested that SSRIs may damage normal sperm DNA integrity and thereby adversely affect fertility [38]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Recent years have seen an increase in the use of antidepressant drugs, especially fluoxetine (FLX), in sensitive populations, such as pregnant and lactating women. Although some evidence suggests a possible endocrine action of FLX, no specific studies have been performed to investigate this hypothesis. In the present study, we investigated the possible (anti)androgenic and (anti)estrogenic actions of FLX using Hershberger, uterotrophic (0.4, 1.7, and 17mg/kg), and reporter gene (7.6-129μM) assays. In the Hershberger assay, no differences were observed in androgen-dependent organ weights. However, the uterotrophic and gene reporter assays indicated a possible estrogenic action of FLX. Uterine weight increased in the 1.7 and 17mg/kg/day groups in the 3-day uterotrophic assay in immature rats. Additionally, noncytotoxic concentrations of FLX induced estrogenic responses and increased the estrogenic response of estradiol in MCF-7 breast cancer cells transfected with luciferase.
    Reproductive Toxicology 04/2012; 34(1):80-5. DOI:10.1016/j.reprotox.2012.04.001 · 2.77 Impact Factor
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    • "Todavia os inibidores seletivos da recaptação da serotonina (ISRS), como a fluoxetina, a sertralina, o citalopram e a paroxetina, foram a classe de antidepressivos mais estudada. A fluoxetina foi comparada com placebo em nove ensaios clínicos: uso contínuo em sete (Menkes et al., 1993; Tratamento da disforia pré-menstrual com antidepressivos Ozeren et al., 1997; Pearlstein et al., 1997; Steiner et al., 1995; Stone et al., 1991; Su et al., 1997; Wood et al., 1992) e uso intermitente em dois (Cohen et al., 2002; Miner et al., 2002). Em todos eles ela foi superior. "
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    ABSTRACT: Introduction: Premenstrual dysphoria (PMD), which affects between 3% and 8% of women during reproductive years, represents a more severe type of premenstrual syndrome. Mood and behavior changes are predominant in PMD. It is believed that there is some kind of link between PMS and mood disorders. Objective: Studying the efficacy of antidepressants in PMD. Methods: We elaborated a review of controlled clinical trials with antidepressants in the treatment of PMD, using the following databases: Medline, LILACS, psycINFO and Cochrane Library. Results: Clomipramine, fluoxetine, sertraline, paroxetine and venlafaxine were superior to placebo in various studies. Discussion: Women with PMD possibly present a serotonergic dysfunction. Conclusion: Some antidepressants, specialy SSRIs, seem to be effective in the treatment of PMD.
    Jornal brasileiro de psiquiatria 01/2006; 55(2). DOI:10.1590/S0047-20852006000200008
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