Randomised trial, 1995
Does progesterone or the anti-anxiety drug alprazolam work better for severe PMS?
Alprazolam was significantly better than both progesterone and placebo, with 37% of women experiencing a 50% reduction in symptoms. Progesterone was no better than placebo.
What they did
This was a randomized trial with 170 women who had severe PMS. Women took either 300 mg of oral progesterone four times daily, 0.25 mg of alprazolam four times daily, or placebo from day 18 through day 2 of the next cycle, for 3 months. Women were randomly assigned to brief or extended clinical visits.
What they found
Alprazolam was significantly better than placebo or progesterone for all measures tested. Thirty-seven percent of the alprazolam group experienced a 50% reduction in symptoms, with no significant withdrawal symptoms. Progesterone was no better than placebo. Brief visits were as effective as extended visits.
What it means for you
Alprazolam effectively reduces severe PMS symptoms when used only during the luteal phase. Progesterone supplementation does not work. More clinical contact does not improve outcomes. This is a large, well-designed study, but alprazolam carries risks of dependency.
170
Number of women who completed treatment
37%
Percentage with 50% symptom reduction on alprazolam
3 months
Treatment duration
About the study
- Original title
- A double-blind trial of oral progesterone, alprazolam, and placebo in treatment of severe premenstrual syndrome
- Authors
- Freeman EW, Rickels K, Sondheimer SJ et al.
- Journal
- JAMA
- Year
- 1995
- Study design
- Randomised trial
- What was tested
- 300 mg four times daily oral progesterone, 0.25 mg four times daily alprazolam, or placebo
- Read the paper
- doi.org/10.1001/jama.1995.03530010065036
Topics
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