Which prescription medication is most effective for relieving premenstrual syndrome symptoms?

Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is recognized as an effective treatment for premenstrual syndrome (PMS) symptoms. The mechanism by which fluoxetine alleviates these symptoms is thought to involve its impact on serotonin levels, which can help improve mood and reduce irritability, anxiety, and depressive symptoms associated with PMS.

Research supports the use of fluoxetine in not only treating the emotional symptoms of PMS but also in reducing physical symptoms such as breast tenderness and bloating, making it a comprehensive option for managing PMS. The treatment can be scheduled to coincide with the luteal phase of the menstrual cycle, when symptoms are typically at their worst, further enhancing its effectiveness.

In contrast to fluoxetine, other medications like alprazolam, while they might provide some relief for anxiety, are not specifically indicated for PMS. Oral contraceptive pills can help regulate cycles and may reduce some symptoms of PMDD (premenstrual dysphoric disorder), but fluoxetine has a more established efficacy profile for the broad spectrum of PMS symptoms. Spironolactone can help with physical symptoms such as bloating and breast tenderness due to its diuretic properties and its ability to reduce fluid retention, yet it does not