Sundblad C, Hedberg M A, Eriksson E
Department of Pharmacology, University of Göteborg, Sweden.
Neuropsychopharmacology. 1993 Sep;9(2):133-45. doi: 10.1038/npp.1993.52.
In a previous controlled trial we have shown that premenstrual irritability and depressed mood (premenstrual syndrome) can be effectively reduced by low doses of the potent (but nonselective) serotonin reuptake inhibitor clomipramine taken each day of the menstrual cycle. The present study was undertaken to examine to what extent intermittent administration of clomipramine, during the luteal phase only, is also effective against premenstrual complaints. Twenty-nine nondepressed women displaying severe premenstrual irritability and/or depressed mood and fulfilling the DSM-III-R criteria of late luteal phase dysphoric disorder were treated daily from the day of ovulation until the onset of the menstruation either with clomipramine (25 to 75 mg) (n = 15) or with placebo (n = 14) for three consecutive menstrual cycles; another nine subjects (seven on clomipramine, two on placebo) dropped out during treatment. In both treatment groups self-rated premenstrual irritability and depressed mood (as registered daily using a visual analogue scale) were significantly reduced during treatment; in the placebo group, this symptom reduction was about 45%, whereas in the clomipramine group it was greater than 70%. The mean premenstrual ratings of irritability and depressed mood during the three treatment cycles were significantly lower in the clomipramine group than in the placebo group. Also with respect to the rating of global improvement, the result obtained with clomipramine was significantly better than that obtained with placebo. The study confirms the previously reported effectiveness of low doses of clomipramine in the treatment of premenstrual syndrome and demonstrates that the time lag between onset of medication and clinical effect is shorter when clomipramine is used for premenstrual syndrome than when it is used for depression, panic disorder, or obsessive compulsive disorder.
在之前的一项对照试验中，我们已经表明，在月经周期的每一天服用低剂量的强效（但非选择性）5-羟色胺再摄取抑制剂氯米帕明，可有效减轻经前易怒和情绪低落（经前综合征）。本研究旨在探讨仅在黄体期间歇性服用氯米帕明对经前不适症状的有效程度。29名无抑郁症状、表现出严重经前易怒和/或情绪低落且符合DSM-III-R晚黄体期烦躁障碍标准的女性，从排卵日开始直至月经来潮，连续三个月经周期每日服用氯米帕明（25至75毫克）（n = 15）或安慰剂（n = 14）；另有9名受试者（7名服用氯米帕明，2名服用安慰剂）在治疗期间退出。在两个治疗组中，治疗期间自我评定的经前易怒和情绪低落（每日使用视觉模拟量表记录）均显著减轻；在安慰剂组中，这种症状减轻约为45%，而在氯米帕明组中则大于70%。氯米帕明组在三个治疗周期中的经前易怒和情绪低落平均评分显著低于安慰剂组。在总体改善评分方面，氯米帕明组的结果也显著优于安慰剂组。该研究证实了先前报道的低剂量氯米帕明治疗经前综合征的有效性，并表明氯米帕明用于经前综合征时，用药开始至临床效果的时间间隔比用于抑郁症、惊恐障碍或强迫症时更短。
