Recurrence of symptoms of premenstrual dysphoric disorder after the cessation of luteal-phase fluoxetine treatment

Objective: The aim of this study was to use the data from two clinical trials to evaluate premenstrual dysphoric disorder symptom severity after the discontinuation of fluoxetine treatment.Study Design: A retrospective analysis of two clinical trials was performed. Patients were treated with fluoxetine or placebo for three cycles, with the use of several different dosing regimens, followed by single blind placebo treatment for one cycle. Assessments of relapse included the daily record of severity of problems, the Sheehan disability scale, the premenstrual tension scale-clinician rated, and the clinical global impressions-severity. Results: Premenstrual dysphoric disorder symptoms significantly increased after fluoxetine discontinuation. The scores did not return to baseline; however, the fluoxetine group was no longer significantly superior to placebo. Conclusion: The two trials demonstrate that, after three cycles of treatment, premenstrual dysphoric disorder symptoms recur within the first cycle after treatment discontinuation. The rapid recurrence of symptoms further supports the view of premenstrual dysphoric disorder as a clinical entity distinct from depression. (Am J Obstet Gynecol 2003;188:887-95.)