Antidepressants in the Treatment of Premenstrual Dysphoric Disorder

Premenstrual dysphoric disorder describes a subset of women who have severe premenstrual symptoms, including at least one mood symptom. It is included in DSM-IV under "Depressive Disorders Not Otherwise Specified." Criteria differentiating premenstrual dysphoric disorder from premenstrual syndrome are the requirements that patients have at least five symptoms, including one mood symptom; have impairment associated with the illness; and prospectively confirm the symptoms. After decades of treatment research on premenstrual dysphoria, the most consistent positive results have been found for selective antidepressants, primarily those that are active at serotonin receptors. Most studies have used continuous daily treatment for acute phase therapy. Further studies should define the role of intermittent and long-term maintenance therapies with these agents.