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Randomised trial, 2008

How well do SSRIs and birth control pills actually work for severe PMS?

SSRIs and birth control pills help some women but not as many as commonly reported. After accounting for placebo effect, approximately 40% of women with severe PMS still don't respond to SSRIs.

Strong study design Women with severe PMS (from 16 reviewed studies with at least 20 participants each)

What they did

Reviewed published studies from 1990 onwards comparing SSRIs and birth control pills to placebo in women with severe PMS. Selected only studies with more than 20 participants that reported the actual number of women who improved, not just average improvement percentages.

What they found

Only 16 studies provided usable data about responder rates. When researchers accounted for placebo effect, the percentage of women who didn't respond to SSRIs or birth control pills was higher than those who did respond. Approximately 40% of women with severe PMS do not respond to SSRIs even though these are considered the first-choice treatment. Birth control pills did not substantially improve response rates.

What it means for you

These treatments help but not as many women as commonly believed when placebo is accounted for. New treatment options are needed, especially for the 40% of women who don't respond to current medications.

40%

Women who don't respond to SSRIs

16

Studies with usable responder rate data

About the study

Original title
Selective serotonin reuptake inhibitors and initial oral contraceptives for the treatment of PMDD: effective but not enough
Authors
Halbreich U
Journal
CNS spectrums
Year
2008
Study design
Randomised trial
What was tested
SSRIs (antidepressants) and combined oral contraceptives versus placebo

Topics