Treatment of premenstrual dysphoria with alprazolam. A controlled study

Thirty women who met DSM-III-R criteria for late luteal phase dysphoric disorder completed a double-blind, randomly assigned crossover treatment study comparing alprazolam with placebo. Alprazolam was found to be superior to placebo. The outcome measures included physicians' global ratings as well as patients' prospective (daily) ratings and retrospective assessments. Improved study design, which addressed methodologic flaws of most previous studies of treatment outcome of "premenstrual syndrome" may account, in part, for our ability to demonstrate significant drug/placebo differences. This includes extensive screening to eliminate women who had premenstrual exacerbations of a more persistent mental illness rather than a discrete premenstrual disorder, use of prospective ratings to confirm retrospective reports of symptom patterns, placebo washout before randomization, and use of patients as their own controls.