What are the different treatment options for treatment of premenstrual syndrome (PMS)?
PMS has been a heavily studied topic over the last few years. There have been many clinical trials investigating treatment options for women who suffer from PMS. The most commonly recommended agents are the selective serotonin reuptake inhibitors (SSRIs). The only SSRI that is FDA approved for PMS is Prozac®. However, Zoloft®, Paxil®, Celexa®, Luvox®, and Buspar® have been studied and proven effective in the treatment of PMS.1,2 These medications are typically given in doses lower than those recommended for other approved indications. The typical starting doses are listed below.
Prozac® (fluoxetine) 10-20 mg daily
Zoloft® (sertraline) 25-50 mg daily
Celexa® (citalopram) 20 mg daily
Paxil® (paroxetine) 10-20 mg daily
Luvox® (fluvoxamine) 50 mg daily
Buspar® (buspirone) 20 mg daily
Side effects of these medications vary with intensity and incidence. Most side effects are dose related and may be alleviated with a decrease in dosage. All of these agents cause CNS disturbances that include somnolence, insomnia, restlessness, and sexual dysfunction at varying degrees. None of the agents are reported to cause CNS side effects at a rate greater than any other. In addition to the CNS effects noted above, Buspar® is also known to cause dream disturbances. These medications may be dosed intermittently during the few days prior to menstruation.
A nonprescription product that has been studied and proven effective in the treatment of PMS is calcium.3 Calcium at dosages between 1200 mg and 1600 mg daily has been shown to reduce the symptoms associated with PMS.
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