Objective To evaluate the effectiveness of vitamin B-6 in the treatment of premenstrual syndrome. from four tests representing 541 individuals. Summary Conclusions are limited by the low quality of most of the tests included. Results suggest that 53123-88-9 IC50 doses of vitamin B-6 up to 100 mg/day time are likely to be of benefit in treating premenstrual symptoms and premenstrual major depression. Key communications Randomised placebo controlled studies of vitamin B-6 treatment for premenstrual symptoms were of insufficient quality to attract definitive conclusions Limited evidence exists to suggest that 100 mg of vitamin B-6 daily (and possibly 50 mg) are likely to be beneficial in the management of premenstrual syndrome Vitamin B-6 was significantly better than placebo in reducing overall premenstrual symptoms and in reducing depression associated with premenstrual syndrome, but the response was not dose dependent No conclusive evidence was found of neurological side effects with these doses A randomised controlled trial of adequate power and quality is needed to compare vitamin B-6 with placebo to establish definitive recommendations for treatment Intro The UK Division of Health and the Medical Control Agency have recently published recommendations to restrict the dose of vitamin B-6 available generally to 10 mg and to limit the dose sold by a pharmacist to less than 50 mg.1 Vitamin B-6 is often used to treat premenstrual syndrome without clear evidence of its efficacy, hence it is timely to re-evaluate vitamin B-6 in the treatment of premenstrual syndrome. Premenstrual syndrome is present when ladies complain of regularly Rabbit Polyclonal to RHOG repeating mental or somatic symptoms, or both, which happen specifically during the luteal phase of the menstrual cycle and which are relieved from the onset of, or during, menstruation. Symptoms can be severe enough to disrupt normal life.2 Mild physiological symptoms happen in approximately 95% of all ladies of reproductive age. Approximately 5% of symptomatic ladies complain of such severe symptoms that their lives are completely disrupted.3 Somatic symptoms of premenstrual syndrome include bloating, weight gain, mastalgia, abdominal discomfort and pain, lack of energy, headache, and exacerbations of chronic illnesses such as asthma, allergies, epilepsy, or migraine. Commonly reported affective changes are dysphoria, irritability, anxiety, pressure, aggression, feelings of being unable to cope, and a sense of loss of control.4 Since the original description of the syndrome in 19315 53123-88-9 IC50 numerous hypotheses have been advanced to explain premenstrual 53123-88-9 IC50 syndrome, but to day the pathogenesis remains unclear and speculative.6 This uncertainty displays the many treatments available7; one reviewer suggested that there were as many as 327 different treatments for premenstrual syndrome.6 Most interventions, however, have been on the basis of informal observations, retrospective data collection, or inadequately controlled trials. The recommended diet allowance for vitamin B-6 is around 2.0 mg/day time, depending on age and protein intake,8 and deficiency of vitamin B-6 is rare.9 Excessive ingestion (2000-6000?mg) of vitamin B-6 causes peripheral neuropathy,10C17 and doses of 200 mg/day time may cause related, although probably reversible, effects.18 Because the effectiveness of vitamin B-6 has not yet been proved, and in light of recent authorities recommendations, we undertook a systematic review of published and unpublished randomised controlled tests where effectiveness of vitamin B-6 was compared with placebo in ladies with premenstrual syndrome. Methods Tests We found reports of published and unpublished medical tests by searching medical databases for tests of vitamin B-6 (pyridoxine) in the management of premenstrual syndrome (MeSH terms used were premenstrual syndrome and pyridoxine, together with title and abstract searches for keywords vitamin and pyridoxine, premenstrual syndrome, PMT, LLPDD, and PMDD). We also contacted relevant pharmaceutical companies developing vitamin B-6 preparations. The tests were recognized by 53123-88-9 IC50 searching Embase (1988 to 1996), Medline (1966 to 1998), Psychlit (1974 to 1997), Cinahl (1982 to 1997), and the database of the Cochrane Controlled Tests Register. We looked references cited in all included and excluded tests to identify any missing studies. All languages were included. Trials investigating the effect of vitamin B-6 on premenstrual symptoms.