Curr Psychiatry Rep. 2002 Dec; 4(6): 435-40.

Current update of hormonal and psychotropic drug treatment of premenstrual dysphoric disorder.

Freeman EW.

Department of Obstetrics and Gynecology, University of Pennsylvania Medical Center, 3400 Spruce Street, 2 Dulles, Mudd Suite, Philadelphia, PA 19104, USA. freemane@mail.med.upenn.edu

This review discusses the current status of diagnosis and treatment of premenstrual dysphoric disorder (PMDD), with an emphasis on studies that have been published in the medical literature during the 2001 to 2002 interval. Serotonergic antidepressants are effective for PMDD, and are currently considered the first-line treatment. Recent clinical trials have shown that selective serotonin reuptake inhibitors, taken only during the symptomatic luteal phase, are also effective for PMDD. One study reported efficacy for a slow-release formulation of fluoxetine that was taken two times during the menstrual cycle. Oral contraceptives still lack definitive evidence of efficacy as a treatment for PMDD, although a new contraceptive formulation has appeared promising for the mood and behavioral symptoms of the disorder. The results of a meta-analysis of the published trials of progesterone and progestins further indicate that these hormones are not effective in the management of PMDD.