PMS: How can my premenstrual syndrome be treated?

J Womens Health (Larchmt). 2006 Jan-Feb;15(1):57-69.

Expert guidelines for the treatment of severe PMS, PMDD, and comorbidities: the role of SSRIs. Steiner M , Pearlstein T , Cohen LS , Endicott J ,

Kornstein SG , Roberts C , Roberts DL , Yonkers K .

Department of Psychiatry and Behavioral Neurosciences, McMaster University, Women's Health Concerns Clinic, St. Joseph's Hospital, Hamilton, Ontario, Canada.mst@mcmaster.ca

The hallmark feature of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) is the predictable, cyclic nature of symptoms or distinct on/offness that begins in the late luteal phase of the menstrual cycle and remits shortly after the onset of menstruation. PMis distinguished from PMS by the severity of symptoms, predominance of mood symptoms, and role dysfunction, particularly in personal relationships and marital/family domains. Several treatment modalities are beneficial in PMand severe PMS, but the selective serotonin reuptake inhibitors (SSRIs) have emerged as first-line therapy. The SSRIs can be administered continuously throughout the entire month, intermittently from ovulation to the onset of menstruation, or semi-intermittently with dosage increases during the late luteal phase. These guidelines present practical treatment algorithms for the use of SSRIs in women with pure PMor severe PMS, PMand underlying subsyndromal clinical features of mood or anxiety, or premenstrual exacerbation of a mood/anxiety disorder.

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