Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review

BMJ 1999;318:1375-1381 ( 22 May )

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Efficacy of vitamin B-6 in the treatment of premenstrual syndrome: systematic review

Katrina M Wyatt, non-clinical lecturer in reproductive endocrinology, ^a Paul W Dimmock, researcher, ^a Peter W Jones, professor, ^b P M Shaughn O'Brien, professor. ^a

^a Academic Department of Obstetrics and Gynaecology, North Staffordshire Hospital, Stoke on Trent ST4 6QG, ^b Department of Mathematics, Keele University, Keele ST5 5BG

Correspondence to: Dr Wyatt mea10{at}keele.ac.uk

Objective: To evaluate the efficacy of vitamin B-6 inthe treatment of premenstrualsyndrome.
Design: Systematic review of published and unpublishedrandomised placebo controlled trials of the effectiveness of vitaminB-6 in the management of premenstrualsyndrome.
Subjects: Nine published trials representing 940 patientswith premenstrualsyndrome.
Main outcome measures: Proportion of women whose overall premenstrualsymptoms showed an improvement over placebo. A secondary analysiswas performed on the proportion of women whose premenstrual depressivesymptoms showed an improvement overplacebo.
Results: Odds ratio relative to placebo for an improvementin overall premenstrual symptoms was 2.32 (95% confidence interval1.95 to 2.54). Odds ratio relative to placebo for an improvementin depressive symptoms was 1.69 (1.39 to 2.06) from four trialsrepresenting 541patients.
Conclusion: Conclusions are limited by the low qualityof most of the trials included. Results suggest that doses ofvitamin B-6 up to 100 mg/day are likely to be of benefit in treatingpremenstrual symptoms and premenstrualdepression.

Key messages

Randomised placebo controlled studies of vitamin B-6 treatment for premenstrual symptoms were of insufficient quality to draw 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 relieving overall premenstrual symptoms and in relieving 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 sufficient power and quality is needed to compare vitamin B-6 with placebo to establish definitive recommendations for treatment

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Rapid Responses:

Read all Rapid Responses

PMS undefined in trials: Yogi Sehgal
bmj.com, 23 May 1999 [Full text]
Systematic review of Vitamin B6 efficacy: Adrian Edwards
bmj.com, 24 Jun 1999 [Full text]