Abstract
The clinical efficacy of a selective serotonin reuptake inhibitor (SSRI) on the symptoms and quality of life (QOL) in women with pre-menstrual dysphoric disorder (PMDD) was evaluated by daily diary evaluation and the use of psychological scales. Thirty-six women diagnosed as having PMDD were enrolled in the study based on the following two inclusion criteria : 1) Women in whom the total score calculated from the Penn Daily Symptom Report (DSR) for the 5 days prior to menstruation was at least 50% higher than that for Days 5-9 of menstruation ; 2) the total DSR score for the 5 days prior to menstruation was over 80 or the score on the day of the maximum symptom severity during the 5 days prior to menstruation was over 15. The changes in the type and severity of symptoms following 3 months of fluvoxamine therapy (50mg/day, in principle) were evaluated based on the DSR, Zung Self-Rating Depression Scale (SDS), State-Trait Anxiety Inventory (STAI), and the World Health Organization Quality of Life Assessment 26 (WHO/QOL-26) scores. After fluvoxamine treatment, the DSR score was 25.1±14.6 on the day of maximum symptom severity during the 5 days prior to menstruation with a total score for the 5 days prior to menstruation of 133.0±72.4, which presented 79.3% and 66.9%, respectively, of the corresponding scores for the untreated period (scores prior to the start of fluvoxamine treatment : control menstruation period) (p<0.05). Significant improvement in the sores for all the domains of WHO/QOL-26, except those for the environmental domain, began to be observed as early as after one cycle of fluvoxamine treatment. The results of this study suggest that treatment with fluvoxamine is extremely effective for obtaining early improvement of the mental symptoms and QOL of patients with PMDD.
