Evidence map›Paper›PMID 40637881›Full record

ReviewArchives of women's mental health2025

Mechanism of intermittent dosing of fluoxetine in premenstrual dysphoric disorder.

Tara Tamton, Pooja Matadar, Audrey Summers, Megan Johnson, Rif S El-Mallakh

Abstract readReview
PubMed Publisher
In one paragraph

Review in Archives of women's mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Tara TamtonMood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, 401 East Chestnut Street, Suie 610, Louisville, KY, 40202, USA.
Pooja MatadarMood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, 401 East Chestnut Street, Suie 610, Louisville, KY, 40202, USA.
Audrey SummersMood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, 401 East Chestnut Street, Suie 610, Louisville, KY, 40202, USA.
Megan JohnsonMood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, 401 East Chestnut Street, Suie 610, Louisville, KY, 40202, USA.
Rif S El-MallakhMood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, 401 East Chestnut Street, Suie 610, Louisville, KY, 40202, USA. rselma01@louisville.edu.ORCID 0000-0002-4992-8016

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeUnderstanding mechanism of action of effective agents for Premenstrual Dysphoric Disorder (PMDD) is necessary to advance care of these patients. It can be successfully treated with fluoxetine, but its efficacy with intermittent use is difficult to understand because of documented delays in the onset of antidepressant action of this drug.

methodsTargeted review of the literature is used to examine the hypothesis that fluoxetine's inhibiton of CYP3A4, which is needed to metabolize estrogen, underlies its utility when dosed intermittently.

resultsWe propose that fluoxetine slows the degradation of estrogen the late luteal phase, thereby increasing its levels and reducing the PMDD symptoms that typically are associated with alterations in hormone concentrations. The hypothesis can be tested by using a potent CYP3A4 inhibitor that has no antidepressant action. Such agents include the antiviral drugs ritonavir and cobicistat which are potent CYP3A4 inhibitors and are currently being used to boost the levels of other antivirals in the treatment of human immunodeficiency virus (HIV). Prospective studies with women with PMDD in this population before and after initiation of CYP3A4 inhibiting anti-retrovirals would help clarify this question.

conclusionConfirmation of this mechanism may open the door to non-SRI treatments for women that do not tolerate SRI agents.

Indexed as

FluoxetinePremenstrual Dysphoric DisorderSelective Serotonin Reuptake InhibitorsCytochrome P-450 CYP3ACytochrome P-450 CYP3A InhibitorsDrug Administration ScheduleEstrogensFemaleHumansLuteal PhaseCYP3A4 protein, humanCytochrome P-450 CYP3ACytochrome P-450 CYP3A InhibitorsEstrogensFluoxetineSelective Serotonin Reuptake InhibitorsCYP3A4EstrogenFluoxetinePremenstrual dysphoric disorder (PMDD)Serotonin reuptake inhibitors

Identifiers

PMID40637881

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.