Expert Guidelines for the Treatment of Severe PMS, PMDD, and Comorbidities: The Role of SSRIs

Steiner, Meir; Pearlstein, Teri; Cohen, Lee S.; Endicott, Jean; Kornstein, Susan G.; Roberts, Carla P.; Roberts, David L.; Yonkers, Kimberly A.

doi:10.1089/jwh.2006.15.57

Cited by 121 publications

(89 citation statements)

References 57 publications

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“…If medication is necessary, SSRI medication is considered the first-line treatment. 2,46,191 SSRI medication may be effective when administered continuously or intermittently (from ovulation to menses). With the recent FDA approval of the oral contraceptive YAZ for women with PMDD desiring oral contraception, there may now be an alternative first-line treatment.…”

Section: Resultsmentioning

confidence: 99%

“…It is generally recommended that clinicians treat the underlying disorder first, and if premenstrual symptoms persist, subsequent daily ratings can identify PMDD. 46 Symptoms of endometriosis, polycystic ovary disease, thyroid disorders, adrenal system disorders, hyperprolactinemia and panhypopituitarism may mimic symptoms of PMS.…”

Section: Epidemiologymentioning

confidence: 99%

“…In these women, the SSRI dosage is increased during the luteal phase and decreased back to the usual dosage at menses. 46 Future studies are also indicated to systematically compare the efficacy and predictors of response to symptom-onset, luteal-phase and continuous daily SSRI dosing in women with PMDD.…”

Section: Antidepressant Medicationmentioning

confidence: 99%

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Premenstrual Dysphoric Disorder: Burden of Illness and Treatment Update

Pearlstein¹,

Steiner²

2012

FOC

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103

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291Five percent of menstruating women have severe premenstrual symptoms and impairment of functioning defined as premenstrual dysphoric disorder (PMDD). Clinically significant premenstrual symptoms occur in at least an additional 20% of menstruating women. The diagnosis of PMDD should be confirmed by prospective symptom charting over 2 menstrual cycles to confirm the timing of the symptoms and to rule out other diagnoses. The burden of illness of PMDD includes disruption of parenting and partner relationships and decreased productivity in work roles. In addition, women with PMDD have increased use of health care services such as clinician visits and increased use of prescription medications and over-the-counter preparations. The etiology of PMDD is multifactorial. In particular, dysregulation of the serotonin and allopregnanolone systems is implicated. Several effective treatment options exist, including serotonergic antidepressant medications and an oral contraceptive that contains ethinyl estradiol and drosperinone. In addition, other hormones that suppress ovulation, anxiolytics, cognitive therapy, chasteberry and calcium may be helpful.Cinq pour cent des femmes menstruées ont des symptômes prémenstruels sévères et une incapacité du fonctionnement appelée trouble dysphorique prémenstruel (TDPM). Au moins 20 % de femmes menstruées de plus ont des symptômes prémenstruels cliniquement significatifs. Il faut confirmer le diagnostic de TDPM en suivant les symptômes de façon prospective au cours de deux cycles menstruels afin de confirmer le moment de l'apparition des symptômes et d'exclure d'autres diagnostics. Le fardeau morbide imposé par le TDPM comprend la perturbation des relations avec les enfants et le partenaire et une baisse de productivité au travail. Les femmes atteintes de TDPM ont en outre recours davantage aux services de santé comme les visites aux cliniciens et prennent davantage de médicaments d'ordonnance et en vente libre. L'étiologie du TDPM est multifactorielle. La dysrégulation des systèmes de la sérotonine et de l'allopregnanolone en particulier est mise en cause. Il existe plus d'un traitement efficace possible, y compris des antidépresseurs sérotonin-ergiques et un contraceptif oral qui contient de l'éthinyloestradiol et de la drosperinone. D'autres hormones qui bloquent l'ovulation, des anxiolytiques, la thérapie cognitive, le gattilier (Vitex agnus castus) et le calcium peuvent en outre aider. Review Paper Examen critique DiagnosisAbout 80% of women report at least mild premenstrual symptoms, 20%-50% report moderate-to-severe premenstrual symptoms, and about 5% report severe symptoms for several days with impairment of functioning.

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Section: Resultsmentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

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Premenstrual Dysphoric Disorder: Burden of Illness and Treatment Update

Pearlstein¹,

Steiner²

2012

FOC

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103

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“…PMDD may be distinguished from PMS by symptom severity, predominance of mood symptoms, and dysfunction in interpersonal relationships [11]. Throughout the article we will now refer to MRD as recently suggested [12].…”

Section: Effects Of Endogenous Endocrine Fluctuationmentioning

confidence: 99%

Hormonal therapy and depression: Are we overlooking an important therapeutic alternative?

Ancelin¹,

Scali²,

Ritchie³

2007

Journal of Psychosomatic Research

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implications: that women vary in vulnerability to mood disorder when abrupt change in steroid levels occur, that these effects could be cumulative across the female lifespan, and that women do not arrive at menopause with equal risk of mood disorders, or equal susceptibility to the effects of hormonal replacement therapy as has been assumed by current clinical research and practice. Conclusion:While hormonal therapies could have positive effects in the treatment and prevention of depressive disorders, further research is required to differentiate hormone-responsive subgroups of women for whom specific hormonal treatments may be most beneficial. To this end we suggest that a multifactorial model of cumulative vulnerability, which takes into account hormonal exposure throughout life, genetic vulnerability and environmental factors, may provide better prediction of treatment response.

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“…Some other studies also stated biological, psychological and socio-cultural reasons in this regard (18). The changes in the level of estrogen, progesterone, androgens and prolactin were considered more important in the PMS syndrome etiology, and brain serotonin production has particularly the central role in this issue (19). Different methods are recommended for relief from this syndrome.…”

Section: Introductionmentioning

confidence: 99%