Elks M L
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock 79430.
South Med J. 1993 May;86(5):503-7. doi: 10.1097/00007611-199305000-00003.
To assess the possible efficacy of fluoxetine hydrochloride in severe PMS (premenstrual syndrome, luteal phase dysphoric disorder), an open trial of this medication was undertaken on women with severe PMS. Of 38 patients seeking evaluation of PMS, 35 met the criteria for diagnosis, and 21 had mild symptoms and were treated symptomatically. Fourteen had more severe symptoms persisting for more than 5 to 6 days of the month, and 11 elected to participate in an open trial of low-dose (20 mg) fluoxetine, an antidepressant. Ten continued treatment for 3 to 20 months, with moderate to marked relief of symptoms during treatment and without problematic side effects (one patient was given 40 mg daily; the remainder received 20 mg daily). On discontinuing therapy, seven have had persisting remissions, and two have returned for another cycle of fluoxetine therapy, with relief. It is unclear whether such a strong positive response to fluoxetine, an antidepressant with particularly good effects in "atypical depression," indicates that the women affected by severe PMS have a cyclic, hormonally induced change in brain chemistry causing a depressive type of condition, or whether they have a true (atypical) mild depression with brief remission due to "perifollicular euphoria" in the estrogenic follicular phase.
为评估盐酸氟西汀对严重经前综合征（PMS，经前期综合征、黄体期烦躁障碍）的可能疗效，对患有严重经前综合征的女性进行了该药的开放试验。在38名寻求经前综合征评估的患者中，35名符合诊断标准，21名症状较轻，接受了对症治疗。14名症状较为严重，每月持续5至6天以上，11名选择参加低剂量（20毫克）氟西汀（一种抗抑郁药）的开放试验。10名患者持续治疗3至20个月，治疗期间症状有中度至明显缓解，且无不良副作用（1名患者每日服用40毫克；其余患者每日服用20毫克）。停药后，7名患者持续缓解，2名患者回来接受另一周期的氟西汀治疗并症状缓解。尚不清楚对氟西汀（一种对“非典型抑郁症”有特别良好效果的抗抑郁药）如此强烈的阳性反应，是否表明受严重经前综合征影响的女性存在一种由激素诱导的大脑化学物质周期性变化，从而导致抑郁状态，或者她们是否患有真正的（非典型）轻度抑郁症，因雌激素卵泡期的“卵泡周围欣快感”而有短暂缓解。
