The purpose of this study is to compare the efficacy of calcium carbonate to fluoxetine in the treatment of moderate to severe PMS. Second, to compare each active agent to a placebo control. Third, to evaluate the efficacy of each treatment for specific symptom clusters (i.e. affective and somatic). Fourth, to determine whether the addition of calcium to on going fluoxetine treatment leads to additional therapeutic benefit.
This is a double blind, randomized, placebo controlled, parallel study that will randomize 60 women at the Yale site into treatment. Participants will be screened at various collaborating ob-gyn centers for possible PMS symptoms, and direct referrals from the community will also be accepted. Subject participation length is about 7 months with 6 scheduled study visits. Methodology: After successfully completing the screening and qualification phase, participants will be randomized to treatment at Visit 1 for 5 cycles of double-blind treatment. Participants will be evaluated monthly during the randomization phase for adverse events, concurrent medication, and primary and secondary efficacy variables. .
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
49
Fluoxetine 20 mg per day for 4 menstrual cycles. For the fifth menstrual cycle, all women will receive calcium. Women on Fluoxetine will continue taking it in addition to 1200mg of calcium.
1200 mg of calcium to be taken for 5 menstrual cycles.
For 5 cycles, women will receive placebo. At the end of the fourth cycle, all women will receive 1200 mg of calcium in addition to the placebo medication.
Yale School of Medicine
New Haven, Connecticut, United States
Comparison of the Change in IDS Symptom Scores Among Groups
IDS = Inventory of Depressive Symptomatology: measures depressive symptoms during the previous premenstrual phase with high internal consistency: sum of responses to 28 of 30 possible items each scored 0 to 3 points with total scoring (0=no symptoms, 84=most severe). This outcome is a measure of effect size between the two trial groups and the placebo group, with the placebo effect size value used as a reference.
Time frame: over duration of treatment, 4 menstrual cycles averaging 4 months after baseline visit
Comparison of the Change in PMTS Symptom Scores Among Groups
PMTS = Premenstrual Tension Syndrome (Observer Rating) Scale: a clinician-administered retrospective scale developed for the study of PMS, a sum of responses to 10 items each with 4 points (0=no symptoms, 40=most severe). This outcome is a measure of effect size between the two trial groups and the placebo group, with the placebo effect size value used as a reference.
Time frame: over duration of treatment, 4 menstrual cycles averaging 4 months after baseline visit
Comparison of the Change in CGI-S Symptom Scores Among Groups
CGI-S = Clinical Global Impression-Severity: a severity scale widely used in psychopharmacology research (1=normal not at all ill, 7=among most extremely ill). This outcome is a measure of effect size between the two trial groups and the placebo group, with the placebo effect size value used as a reference.
Time frame: over duration of treatment, 4 menstrual cycles averaging 4 months after baseline visit
Comparison of the Change in DRSP Symptom Scores Among Groups
DRSP = Daily Record of Severity of Problems, which combines responses to 21 items each with scale: 1=no symptoms, 6=extreme. This outcome is a measure of effect size between the two trial groups and the placebo group, with the placebo effect size value used as a reference.
Time frame: over duration of treatment, 4 menstrual cycles averaging 4 months after baseline visit
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Comparison of the Change in CGI Improvement Scores Among Groups
CGI-I = Clinical Global Impression Improvement: the improvement subscale of CGI measuring change at each visit as compared to visit 1 (1=very much improved, 7=very much worse). This outcome is a measure of effect size between the two trial groups and the placebo group, with the placebo effect size value used as a reference.
Time frame: over duration of treatment, 4 menstrual cycles averaging 4 months after baseline visit
Proportion of Participants With DRSP LOCF Response to Treatment (50% Improvement)
DRSP: Daily Record of Severity of Problems, which combines responses to 21 items each with scale: 1=no symptoms, 6=extreme. LOCF: the last observation carried forward.
Time frame: over duration of treatment, 4 menstrual cycles averaging 4 months after baseline visit
Proportion of Participants With IDS LOCF Response to Treatment (50% Improvement)
IDS: Inventory of Depressive Symptomatology: measures depressive symptoms during the previous premenstrual phase with high internal consistency: sum of responses to 28 of 30 possible items each scored 0 to 3 points with total scoring (0=least severe, 84=most severe). LOCF: last observation carried forward.
Time frame: over duration of treatment, 4 menstrual cycles averaging 4 months after baseline visit
Proportion of Participants With PMTS LOCF Response to Treatment (50% Improvement)
PMTS: Premenstrual Tension Syndrome (Observer Rating) Scale: a clinician-administered retrospective scale developed for the study of PMS, a sum of responses to 10 items each with 4 points (0=no symptoms, 40=most severe). LOCF: last observation carried forward.
Time frame: over duration of treatment, 4 menstrual cycles averaging 4 months after baseline visit
Proportion of Participants With DRSP Visit-wise Response to Treatment (50% Improvement)
Visit-wise response considers participants who remained in the study until Visit 5 and provided data for the visit. DRSP = Daily Record of Severity of Problems, which combines responses to 21 items each with scale: 1=no symptoms, 6=extreme.
Time frame: over duration of treatment from baseline to visit 5, including 4 menstrual cycles averaging 4 months after baseline visit
Proportion of Patients With IDS Visit-wise Response to Treatment (50% Improvement)
Visit-wise response considers participants who remained in the study until Visit 5 and provided data for the visit. IDS = Inventory of Depressive Symptomatology: measures depressive symptoms during the previous premenstrual phase with high internal consistency, sum of responses to 28 of 30 possible items each scored 0 to 3 points with total scoring (0=no symptoms, 84=most severe).
Time frame: over duration of treatment from baseline to visit 5, including 4 menstrual cycles averaging 4 months after baseline visit
Proportion of Patients With PMTS Visit-wise Response to Treatment (50% Improvement)
Visit-wise response considers participants who remained in the study until Visit 5 and provided data for the visit. PMTS = Premenstrual Tension Syndrome (Observer Rating) Scale: a clinician-administered retrospective scale developed for the study of PMS, a sum of responses to 10 items each with 4 points (0=no symptoms, 40=most severe).
Time frame: over duration of treatment from baseline to visit 5, including 4 menstrual cycles averaging 4 months after baseline visit