Fluoxetine for PMS/PMDD

Fluoxetine (under the trade name Sarafem) is indicated for premenstrual dysphoric disorder (PMDD).

PreMenstrual dysphoric disorder, a severe form of premenstrual syndrome (PMS), occurs just prior to menstruation. PMDD is characterized by significant depression, dysphoria, irritability, lethargy, decreased interest in life activities.

Fluoxetine relieves both the mood and physical symptoms of PMDD. It decreases irritability, mood swings, tiredness, tension, and breast tenderness. Many women also experience an improved interest in social activities.

The researchers found out that allopregnanolone (ALLO), a breakdown substance of progesterone, usually inhibits activity in the brain circuits that control emotional behaviour. When the levels of progesterone, and hence ALLO, in the brain drop during the final stages of the premenstrual period, that natural inhibition is turned off. As a consequence these brain circuits become more excitable, making the person more responsive to stress, anxiety, and aggressive behaviour.

Fluoxetine (Sarafem) raises levels of ALLO rather quickly and this occurres in response to a very low dose1.

Fluoxetine dose for PMDD/PMS: 20 mg per day. It may be taken either throughout the full menstrual cycle or intermittently only during the 2 weeks before menstruation begins (the luteal phase).

See also


  • 1. Pinna G, Costa E, Guidotti A. Fluoxetine and norfluoxetine stereospecifically and selectively increase brain neurosteroid content. Psychopharmacology (Berl). 2006 Jun;186(3):362-72.

Author: OriginalDrugs Team
Last reviewed: February, 2015

Quick facts

  • Serafem decreases irritability, mood swings, tiredness, and tension.