Article

Pyridoxine (vitamin B6) therapy for premenstrual syndrome

Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Teheran, Tehrān, Iran
International Journal of Gynecology & Obstetrics (Impact Factor: 1.56). 02/2007; 96(1):43-4. DOI: 10.1016/j.ijgo.2006.09.014
Source: PubMed
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    ABSTRACT: Das prämenstruelle Syndrom (PMS) tritt häufig bei jungen Frauen im gebärfähigen Alter auf, es kann aber auch erst zu Beginn der Perimenopause manifest werden. Etwa 5% der Patientinnen leiden unter einer schweren Form, der prämenstruellen dysphorischen Störung (PMDS). Aufgrund einer fehlenden einheitlichen pathophysiologischen Genese erfolgt die Behandlung symptomatisch in Form eines multikausalen Stufentherapiekonzeptes nach eingehender Diagnostik und Ausschluss anderer Erkrankungen. Neben einer Vielzahl an sowohl pharmakologischen als auch nichtmedikamentösen Strategien ist die Gabe von Vitamin B6 eine mögliche Option zur Linderung insbesondere der psychischen Beschwerden, die für die betroffenen Frauen oftmals eine größere Beeinträchtigung darstellen können als die körperlichen Symptome. Der vorliegende Beitrag erläutert die klinische Wirksamkeit von Vitamin B6 bei PMS aufgrund der aktuellen wissenschaftlichen Literatur.
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    ABSTRACT: To evaluate the current nonpharmacologic and pharmacologic treatment options for symptoms of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). Literature was obtained through searches of MEDLINE Ovid (1950-March week 3, 2008) and EMBASE Drugs and Pharmacology (all years), as well as a bibliographic review of articles identified by the searches. Key terms included premenstrual syndrome, premenstrual dysphoric disorder, PMS, PMDD, and treatment. All pertinent clinical trials, retrospective studies, and case reports in human subjects published in the English language were identified and evaluated for the safety and efficacy of pharmacologic and nonpharmacologic treatments of PMS/PMDD. Data from these studies and information from review articles were included in this review. Selective serotonin-reuptake inhibitors (SSRIs) have been proven safe and effective for the treatment of PMDD and are recommended as first-line agents when pharmacotherapy is warranted. Currently fluoxetine, controlled-release paroxetine, and sertraline are the only Food and Drug Administration-approved agents for this indication. Suppression of ovulation using hormonal therapies is an alternative approach to treating PMDD when SSRIs or second-line psychotropic agents are ineffective; however, adverse effects limit their use. Anxiolytics, spironolactone, and nonsteroidal antiinflammatory drugs can be used as supportive care to relieve symptoms. Despite lack of specific evidence, lifestyle modifications and exercise are first-line recommendations for all women with PMS/PMDD and may be all that is needed to treat mild-to-moderate symptoms. Herbal and vitamin supplementation and complementary and alternative medicine have been evaluated for use in PMS/PMDD and have produced unclear or conflicting results. More controlled clinical trials are needed to determine their safety and efficacy and potential for drug interactions. Healthcare providers need to be aware of the symptoms of PMS and PMDD and the treatment options available. Treatment selection should be based on individual patient symptoms, concomitant medical history, and need for contraception.
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