To treat the emotional symptoms of PMDD (e.g., depression, tearfulness, mood swings, anxiety, anger, irritability, fatigue, difficulty concentrating), the majority of experts recommend antidepressant medications. Research shows that antidepressants help both the emotional symptoms of PMDD and often the physical symptoms as well. While there are many types of antidepressants available, for PMDD, the experts recommend antidepressants called selective serotonin reuptake inhibitors (SSRIs), which affect a brain chemical called serotonin.
Selective serotonin-reuptake inhibitors (SSRIs) are antidepressant drugs that can treat PMDD. SSRIs include fluoxetine (Prozac, Sarafem), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), and citalopram (Celexa).
SSRIs can relieve physical symptoms, irritability, and tension. In fact, SSRIs appear to relieve PMS-related depression much faster than major depression. Women with PMDD, but without major depression, need only take SSRIs during the 14-day premenstrual period. This approach, called intermittent treatment, causes fewer side effects than when SSRIs are used to treat major depression.
Medication for PMDD include antidepressants, antianxiety drugs, analgesics, hormones and diuretics. These are explained as under.
Antidepressants Medication for PMDD
There are now three medications (fluoxetine [Sarafem], paroxetine controlled-release [Paxil CR] and sertraline [Zoloft]) that have been approved by the United States Food and Drug Administration (FDA) for treating PMDD.
Anxiolytics (Antianxiety Drugs) Medication for PMDD
When anxiety symptoms are an outstanding feature of PMDD, antianxiety drugs are sometimes used. Some of the main antianxiety drugs are Alprazolam (Xanax and others), Clonazepam (Klonopin and others) and Lorazepam (Ativan and others). Alprazolam, a high-potency benzodiazepine with mood-enhancing and anxiolytic effects, has been shown to be somewhat effective in patients with PMS. Drugs of this type tend to work quickly and may be used either as needed or regularly. Dependence and tolerance are occasional problems with these drugs.
A different type of antianxiety drug is buspirone (BuSpar and others), which is used at times for PMDD but is not high on the list of recommendations.
Analgesics (Pain Relievers) Medication for PMDD
There are many pain relievers that can be helpful if pain is a prominent feature of PMDD, however, they are not particularly useful as overall treatments for the disorder. These drugs are used more commonly to treat cramps that occur during menses, a condition known as dysmenorrhea.
Hormones Medication for PMDD
There are two hormonal approaches for treating PMDD. One involves stopping ovulation either with a drug or surgically. Oral contraceptives (birth control pills) are used often to treat premenstrual symptoms, but somewhat surprisingly they have not been extensively studied and their effectiveness for PMDD is not well-established. Danazol (Danocrine), a weak androgen prescribed for patients with endometriosis, fibrocystic breast disease, and hereditary angioneurotic edema, is sometimes used to treat PMDD.
There is a class of drugs known as gonadotropin-releasing hormone (GnRH) agonists that prevent ovulation. These drugs are usually reserved for women who have severe PMDD that has not responded to better established and better tolerated treatments.
The second hormonal approach to PMS/PMDD is the use of progesterone or estrogen to directly relieve symptoms. More study is needed to see just how this might fit into the treatment of PMDD.
Diuretics Medication for PMDD
Diuretics could improve physical and psychologic symptoms.
PMDD Premenstrual Dysphoric Disorder - Learn about basics of PMDD, some statistics related to PMDD and its diagnosis criterion.
PMDD Information - "Premenstrual Dysphoric Disorder" (PMDD) is a real biological condition for which women seek treatment--and for which effective treatment is available.
PMDD Treatment - Treatments include medication, lifestyle changes, supportive psychotherapy and nutritional approches.
PMDD Medication - To treat the emotional symptoms of PMDD (e.g., depression, tearfulness, mood swings, anxiety, anger, irritability, fatigue, difficulty concentrating), the majority of experts recommend antidepressant medications.
PMDD Symptoms - Symptoms occur during the last week of most menstrual cycles and usually improve within a few days after the period starts.
Postpartum Depression basics and treatment : Many new mothers feel sad, afraid, angry, or nervous after their baby is born. These feelings, called postpartum or "baby" blues, are very common.