Impact of GABA-Enhancing Agents on Cortical GABA Concentrations Across the Menstrual Cycle in Women

Study Overview
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Brief Summary
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The goal of this series of challenge studies is to examine the impact of menstrual cycle phase on cortical GABA response to administration of agents with either direct (benzodiazepines) or indirect (progesterone, fluoxetine) GABA modulating properties. While the impact of these agents on cortical GABA levels in women with premenstrual dysphoric disorder (PMDD) is of interest, this study is designed primarily for those women without a psychiatric illness.

Official Title
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The Impact of GABA-Enhancing Agents on Cortical GABA Concentrations Across the Menstrual Cycle in Women

Conditions
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Healthy

Intervention / Treatment
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* Drug: Fluoxetine
* Drug: Zolpidem
* Drug: Progesterone


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women ages 18-45 and able to give voluntary written informed consent; Regular menstrual periods of 24-35 days in length; Body mass index 18.5 to 30 kg/m2; No past or present DSM-IV psychiatric or substance dependence diagnosis by structured diagnostic interview (SCID-NP); no substance abuse history within the previous 2 years; Absence of mood symptoms across the menstrual cycle during one month of prospective daily ratings with the Daily Record of Severity of Problems (DRSP); the DRSP is based on the DSM-IV research criteria for premenstrual dysphoric disorder (PMDD) and has been used in numerous studies to confirm the presence or absence of significant premenstrual mood and behavioral difficulties; Must be willing and able to participate in at least three of the four challenge paradigms. Exclusion Criteria: Medical, neurologic or cerebrovascular disorder (CVA, seizure disorder, etc.); Family history of first degree relative with an Axis I psychiatric or substance dependence disorder (excepting alcohol and nicotine) (per subject report); Current treatment with psychoactive medication; Diabetes controlled by means other than diet; Use of steroid contraceptives (any method involving hormones) within the previous 4 months; Habitual consumption of more than 7 alcoholic drinks per week or more than 2 drinks on any particular occasion; must be willing to abstain from alcohol consumption for 48 hours prior to each 1H-MRS scan; Implanted metallic devices.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Zolpidem 1<br>Zolpidem will be administered twice to each participant; once in the follicular and luteal phases of the menstrual cycle. | Drug: Zolpidem<br>* Zolpidem 10 mg by mouth in the follicular and luteal phase of the menstrual cycle per participant.<br>* Other names: Ambien;|
| Experimental: Progesterone 2<br>Progesterone will be administered twice to each participant; once in both the follicular and luteal phases of the menstrual cycle. | Drug: Progesterone<br>* Progesterone 800 mg by mouth will be administered to each participant once in the follicular and luteal phases of the menstrual cycle.<br>* Other names: Prometrium;|
| Experimental: Fluoxetine 3<br>Fluoxetine will be administered twice to each participant; once in both the follicular and luteal phases of the menstrual cycle. | Drug: Fluoxetine<br>* Fluoxetine 20 mg by mouth in the follicular and luteal phase of the menstrual cycle per participant.<br>* Other names: Prozac;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To Determine the Impact of GABA-A Receptor Agonists (Benzodiazepines, Allopregnanolone) and Other GABA-modulating Agents (Fluoxetine) on Cortical GABA Levels by Menstrual Cycle Phase as Measured Using 1H-MRS in Healthy Controls. | This study was conducted at Yale University almost two decades ago. Our group at the University of Pennsylvania only has very basic information about this study. This includes the number of participants, which was 8, and the fact that no adverse events occurred. Staff members at the University of Pennsylvania do not have access to any additional study data. The contact person who initially entered this study protocol information is no longer at the University of Pennsylvania and we are unable to contact for additional information. | Each medication will be administered 2 times during a 1-month menstrual cycle. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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menses, women, healthy controls, Healthy females with regular menstrual cycles