Citalopram increases pregnanolone sensitivity in patients with premenstrual syndrome: an open trial

We have investigated the ability of citalopram, a serotonin reuptake inhibitor, to alter the functional sensitivity to a neuroactive steroid during the late luteal phase in twelve women with premenstrual syndrome. Sensitivity to pregnanolone was assessed by comparing the effect of three increasing doses of intravenous pregnanolone on saccadic eye velocity (SEV) and self-rated sedation. Testings were performed in two consecutive menstrual cycles; without treatment and during citalopram treatment. During citalopram treatment, pregnanolone injections induced a significant SEV reduction compared to vehicle, whereas during the pre-treatment cycle there was no significant change in SEV response between vehicle and pregnanolone injections. Citalopram treatment did not alter the self-rated sedation response to pregnanolone compared to vehicle in either study cycle. These findings indicate that treatment with a selective serotonin reuptake inhibitor in the luteal phase increases the pregnanolone sensitivity in patients with premenstrual syndrome.