Intermittent Fluoxetine Dosing for PMDD
Intermittent fluoxetine dosing for premenstrual dysphoric disorder (PMDD) is recommended as 20 mg once daily restricted to the luteal phase. [1]
Intermittent Dosing Schedule
- Start fluoxetine at a daily dose of 20 mg approximately 14 days before the anticipated onset of menstruation. [1]
- Continue fluoxetine through the first full day of menses. [1]
- Repeat the intermittent schedule with each new menstrual cycle. [1]
Key Evidence Supporting This Dosing Approach
- Luteal-phase–only SSRI administration is supported by clinical trial evidence showing efficacy for PMDD versus placebo using dosing limited to the 14 days preceding menses. [2]
- Intermittent (luteal-phase–only) fluoxetine regimens starting on day 14 through menstrual flow have been described in the PMDD literature. [2]
Clinical Dosing Clarifications
- The intermittent regimen above is an evidence-based dosing schedule for fluoxetine in PMDD and aligns with labeling definitions of intermittent use (luteal-phase dosing from 14 days before anticipated onset through the first full day of menses). [1]
Targets and Goals of Therapy
- The goal of fluoxetine therapy in PMDD is symptom reduction during the premenstrual period with resolution by the time menses begins. [2]