Premenstrual dysphoric disorder: How to alleviate her suffering
Accurate diagnosis, tailored treatments can greatly improve women’s quality of life
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Treatment selection
To enhance compliance and improve the likelihood of successful treatment, tailor treatment decisions to your patient’s needs. Carefully discuss with your patient the evidence-based literature to select the best option for her. Factors to consider when counseling patients include:
- the patient’s age, cigarette smoking habits, and body mass index, which may contraindicate oral contraceptives
- does the patient have regular cycle lengths?
- can she adhere to an on-off schedule? If so, intermittent SSRI dosing may be a good treatment option
- does the patient have irregular cycles?
- is there evidence that symptoms persist into the follicular phase, albeit at a lower level? If so, continuous SSRI dosing may be the best option.
Related Resources
- American Psychiatric Association. DSM-5 development: D 04 Premenstrual dysphoric disorder. www.dsm5.org/proposedrevision/pages/proposedrevision.aspx?rid=484.
Drug Brand Names
- Citalopram • Celexa
- Clomipramine • Anafranil
- Clonidine • Catapres, others
- Danazol • Danocrine
- Drospirenone/ethinyl estradiol • Yaz
- Escitalopram • Lexapro
- Fluoxetine • Prozac
- Leuprolide • Lupron
- Levonorgestrel/ethinyl estradiol • Seasonale, others
- Paroxetine • Paxil
- Progesterone • Prometrium
- Sertraline • Zoloft
- Spironolactone • Aldactone
- Venlafaxine • Effexor
Disclosures
Drs. Wakil and Girdler report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products
Dr. Meltzer-Brody receives research/grant support from AstraZeneca, The Foundation of Hope, and the National Institutes of Health.
