Food "cravings" and the acute effects of alprazolam on food intake in women with premenstrual dysphoric disorder

Women with premenstrual dysphoric disorder (PMS) report negative mood premenstrually, and increased food cravings and food intake. Although the benzodiazepine alprazolam has been used to treat PMS, alprazolam has been shown to increase food intake. The present study investigated the acute effects of alprazolam (0, 0.25, 0.50, 0.75 mg) on food intake in 19 women with PMS. Each dose was tested once during the premenstrual phase and again during the postmenstrual phase. Each session, before drug administration, participants completed a Food Desirability Questionnaire and selected lunch: which was consumed 3.5 h after drug administration. Desire for foods containing fat were significantly increased premenstrually compared to postmenstrually, while desires for carbohydrate (CHO) alone and beverages did not change as a function of menstrual cycle phase. Cognitive Restraint scores predicted the amount of food consumed, i.e. restrained eaters consumed less food at lunch. Alprazolam significantly increased food intake, specifically fat, premenstrually compared to postmenstrually. Restrained eaters consumed 26% more calories premenstrually following 0.75 mg alprazolam relative to placebo, whereas unrestrained eaters consumed 9% more calories. Thus, women with PMS, particularly restrained eaters, are more sensitive to the food-intake increasing effects of alprazolam premenstrually. (C) 1999 Academic Press.