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Prescription Drug Treatments for PMS and PMDD

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Updated September 26, 2013

Antidepressants for PMS and PMDD

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressants which are extremely effective for the treatment of PMS symptoms. SSRIs approved for the treatment of PMS and PMDD include Prozac (fluoxetine), Zoloft (sertraline), and Celexa (citalopram). Sixty percent to 75% of women with PMDD have experienced a significant improvement in their symptoms with antidepressant treatments. Your doctor may prescribe this treatment only during the luteal phase of your menstrual cycle, or for continuous daily use, depending on your individual symptoms.

The biggest side effects of SSRIs in women are sexual side effects, particularly difficulty achieving orgasm. If you experience sexual side effects from taking SSRIs, talk to your doctor who may want to prescribe a lower dose or another antidepressant to treat your PMS or PMDD symptoms.

Anti-anxiety Drugs for PMS and PMDD

Your doctor can prescribe anti-anxiety drugs such as Xanax (alprozalam), if you experience significant anxiety during the 14 days prior to the onset of menstruation and other treatments fail to provide relief. However, it’s important to understand that this type of medication has a high risk for addiction. If you doctor prescribes anti-anxiety medications to treat your PMS or PMDD symptoms, make sure you take the medication only during the luteal phase of your menstrual cycle to reduce your risk of addiction.

Drugs That Affect Hormone Production for PMS and PMDD

The final type of prescribed medications for the treatment of PMS and PMDD are medicines that affect hormone production. These drugs include gonadotropin releasing hormone agonists (GnRH) such as Lupron (leuprolide), a GnRH-like drug called Danocrine (danazol), and oral contraceptives.

While PMS and PMDD affect women who take oral contraceptives equally, some women find an improvement in their symptoms when they begin taking birth control pills. However, some women experience an increase in the intensity of their PMS and PMDD symptoms when they begin taking oral contraceptives.

Continuous birth control pills may help relieve the symptoms of PMS and PMDD experienced by some women. This is believed to be because without the normal hormonal fluctuations that occur during the menstrual cycle, PMS and PMDD simply don’t occur.

Yaz (ethinyl estradiol / drosperinone) is the only oral contraceptive FDA-approved for the treatment of PMDD, improving the symptoms of 62% of the women in one study.

If you have PMS or PMDD, talk to your doctor about your treatment options if any treatment you try does not provide the desired results.

Sources:

Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD); UpToDate; http://www.uptodate.com/patients/content/topic.do?topicKey=endocrin/10662&title=PMDD+(Premenstrual+syndrome); accessed 07/24/08. Chasteberry NCCAM Herbs at a Glance; NCCAM; http://nccam.nih.gov/health/chasteberry/; accessed 07/25/08. Sleeping Difficulty; MedlinePlus; http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm; accessed 07/28/08.

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