---
title: Does N-acetylcysteine (NAC) work for PMDD as well as fluoxetine?
description: Yes. NAC worked about as well as fluoxetine for PMDD, and both worked better than placebo.
url: https://niyora.com/research/papers/assessment-of-n-acetylcysteine-as-an-alternative-for-the-treatment-of-the-2020/
---

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- Does N-acetylcysteine (NAC) work for PMDD as well as fluoxetine?

Randomised trial, 2020

# Does N-acetylcysteine (NAC) work for PMDD as well as fluoxetine?

Yes. NAC worked about as well as fluoxetine for PMDD, and both worked better than placebo.

 Moderate study design

119 childbearing women

## What they did

119 women were randomly assigned to take either 450 mg NAC twice daily, 10 mg fluoxetine twice daily, or placebo daily for 2 weeks of the menstrual cycle for 2 menstrual cycles. Symptom severity was measured with questionnaires.

## What they found

All three groups improved significantly. NAC and fluoxetine worked equally well, with no statistical difference between them. Both NAC and fluoxetine were significantly better than placebo.

## What it means for you

NAC might be a useful alternative to fluoxetine for PMDD. However, this was a relatively short study and researchers recommend larger studies with longer treatment to confirm these findings.

119

women studied

450 mg

NAC dose twice daily

2

menstrual cycles treated

## About the study

Original title Assessment of N-acetylcysteine as an Alternative for the Treatment of the Premenstrual Dysphoric Disorder: A Randomized Clinical Trial Authors Fatemeh Rajabi, Monireh Haghanifar, Mohammad Javad Tarrahi Journal Journal of Pharmaceutical Care Year 2020 Study design Randomised trial Participants 119 What was tested N-acetylcysteine 450 mg twice daily versus fluoxetine 10 mg twice daily versus placebo, for 2 weeks per cycle for 2 menstrual cycles Open access Yes Read the paper [doi.org/10.18502/jpc.v7i4.2377](https://doi.org/10.18502/jpc.v7i4.2377)

## Topics

[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[SSRIs and antidepressants](https://niyora.com/research/topics/treatment-ssri/)

Research tells you what helps on average. Niyora helps on the day it hits.

Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor.

## Related studies

Systematic review, 2026

Does continuous paroxetine or birth control work better for PMDD?

Systematic review, 2026

Are there differences in brain activity in women with PMDD?

Study, 2026

Are SSRIs the first treatment doctors recommend for PMDD?

Randomised trial, 2025

Does taking an antidepressant only during the second half of your cycle reduce anger and aggression in PMDD?

Systematic review, 2024

What are the best treatments for PMDD and PMS?

Review, 2024

What are the most effective treatments for PMDD?

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