Menkes 1992.

Methods	Randomised, double‐blind, placebo‐controlled, crossover trial 2x3 cycles
Participants	Country: New Zealand Site: No details Recruitment: Community sample of volunteers ‐ 23 women screened. After two cycles of screening 21 women had PMS confirmed by psychiatric interview and agreed to be randomised. 21 randomised, 16 completed. Mean age 37.8±4.7 years. 23 women met provisional criteria, Daily Symptom Scores and ratings of PAF Inclusion: Age 18 to 48 years. Confirmation of PMS by psychiatric evaluation Exclusion: Taking regular psychotropics, diuretics, or using hormonal contraception. Any appreciable menstrual irregularity, psychiatric or substance use disorder
Interventions	Screening: Three cycles of screening Placebo run‐in: None Intervention: Crossover trial of 20mg fluoxetine PO every day for 3 cycles versus placebo PO every day for 3 cycles with 12 day washout period between arms Timing of administration: Medication commenced on twelfth day of menstrual cycle and continued through three cycles stopping at the onset of menses Summary measures: Mean data over three months of treatment presented in paper
Outcomes	Premenstrual Assessment Form Side effects
Notes	No data extracted as unable to distinguish first and second arm of study Same patient group as excluded study, Menkes 1992 Daily symptom rating Fluoxetine provided by Eli‐Lilly
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method not reported
Allocation concealment (selection bias)	Unclear risk	Method not reported
Blinding (performance bias and detection bias) All outcomes	Low risk	Double blind (patient and rater)
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Five women excluded from analysis (23%), two for protocol violation and three due to adverse effects ‐ no details as to which arm of the crossover this occurred in
Selective reporting (reporting bias)	Unclear risk	Tolerability assessed at end of each treatment phase, not prospectively. Adverse events not reported by treatment arm
Other bias	Unclear risk	Crossover trial with 12‐day washout period