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Sir: It has recently been demonstrated that venlafaxine, a serotonin-norepinephrine reuptake inhibitor, is effective for the treatment of premenstrual dysphoric disorder (PMDD).1,2 However, withdrawal reactions with venlafaxine have been reported. 3-7 Most of these withdrawal reactions were noted in patients with depressive disorder and associated with daily venlafaxine doses of 150 mg or more