Table of Contents
Other SSRIs sometimes prescribed for PMDD include citalopram (Celexa, generic) and escitalopram (Lexapro, generic). The serotonin-noradrenaline reuptake inhibitor venlafaxine (Effexor, generic) has also shown benefit in some studies.
SSRIs appear to work much faster for relieving PMS-related depression than when used in major depression. These drugs are typically prescribed with either continuous (daily) dosing throughout the month or an intermittent dosing regimen. With intermittent dosing, women take the antidepressant during the 14-day premenstrual period of their luteal phase.
General side effects of SSRIs may include nausea, drowsiness, headache, weight gain and sexual dysfunction. Antidepressants may increase the risk for suicidal thinking and behavior in young adults ages 18 - 24. This risk for “suicidality” generally occurs during the first few months of treatment.
[For more information, see In-Depth Report #8: Depression.]
Antianxiety Drugs
Antianxiety drugs (called anxiolytics) may be helpful for women with severe premenstrual anxiety that is not relieved by SSRIs or other treatments.
Benzodiazepines. The standard anxiolytics are the benzodiazepines, with alprazolam (Xanax, generic) most often used for PMS. Doctors, however, generally do not recommend these drugs for PMS-related anxiety. Dependence is a risk and can occur after as short a time as 3 months of use. (Using alprazolam for only a few days per month when symptoms are most severe reduces this risk.) Common side effects are daytime drowsiness and a hung-over feeling. Respiratory problems may be worsened. Benzodiazepines also increase appetite, particularly for fats. Overdose is very serious, although rarely fatal. Benzodiazepines are potentially dangerous when used in combination with alcohol.
Buspirone.. Buspirone (BuSpar, generic) is an anti-anxiety drug that may help reduce premenstrual irritability. Unlike benzodiazepines, buspirone is not addictive. Buspirone also seems to have less pronounced side effects than benzodiazepines and no withdrawal effects, even when the drug is discontinued quickly. Common side effects include dizziness, drowsiness, and nausea. [For more information, see In-Depth Report #28: Anxiety.]
Hormone Therapies
Hormone therapies are used to interrupt the hormonal cycle that triggers premenstrual syndrome symptoms. One method to accomplish this is through birth control pills.
Previous Section
Review Date: 07/26/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine,
Harvard Medical School; Physician, Massachusetts General Hospital.
Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M.,
Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
