Dysphoria premenstrual

Wikander I, Sundblad C, Andersch B, et al Citalopram in premenstrual dysphoria is intermittent treatment during luteal phases more effective than continuous medication throughout the menstrual cycle J Clin Psycho-pharmacol 18 390-398, 1998... 

A three-arm trial during six menstrual cycles evaluating the efficacy and safety of fluoxetine treatment of premenstrual dysphoria. Both 20 and 60 mg/day were significantly more effective than placebo, without any salient benefit of the higher dose however, the women on 60mg/daj of fluoxetine reported significantly more side effects than those at the lower dose or placebo. Based on the results of this three-arm fixed-dose and similar trials, the recommended dose in this indication is 20 mg of fluoxetine (Steiner et ti/., 1995). 

Harrison WM, Endicott J, Nee J. Treatment of premenstrual dysphoria with alprazolam. Arch Gen Psychiatry 1990 47 270-275. 

SSRIs in particular have come to be used increasingly in a variety of conditions other than major depression. Table 8.4 summarizes the uses for which SSRIs have been approved, based on the finding of significant beneficial effects in controlled clinical trials. In addition, agents in this class in controlled trials have shown usefulness in premenstrual dysphoria, borderline personality disorder, obesity, smoking cessation, and alcoholism (17). 

Landen M, Eriksson O, Sundblad C, et al. Compounds with affinity for serotonergic receptors in the treatment of premenstrual dysphoria A comparison of buspirone, nefazodone and placebo. Psychopharmacology (Berl) 2001 155 292-298. 

Steiner, M., Steinberg, S., Stewart, D., Carter, D., Berger, C., Reid, R., Grover, D. (Canadian Fluoxetine/Premenstrual Dysphoria Collaborative Study Group), and Streiner, D., Fluoxetine in the treatment of premenstrual dysphoria, N. Engl. J. Med., 332, 1529, 1995. 

Steinberg, S., Annable, L., Young, S. N., and Liyanage, N., A placebo-controlled clinical trial of L-tryptophan in premenstrual dysphoria, Biol. Psychiatr., 45, 313,1999. 

LF sometimes is used as an alternative or adjunct to antidepressants in severe, especially melancholic, recurrent depression, as a supplement to antidepressant treatment in acute major depression, including in patients who present clinically with only mild mood elevations or hypomania (bipolar II disorder), or as an adjunct when later response to an antidepressant alone is unsatisfactory. In major affective disorders, LT has stronger evidence of reduction of suicide risk than any other treatment. Clinical experience also suggests the utility of IF in the management of childhood disorders that are marked by adult-like manic depression or by severe changes in mood and behavior, which are probable precursors to bipolar disorder in adults. Evidence of efficacy of Li in many additional episodic disorders (e.g., premenstrual dysphoria, episodic alcohol abuse, and episodic violence) is unconvincing. 

The primary uses for the SSRIs include MMD and bipolar depression (fluoxetine, paroxetine, sertraline, and citalopram), atypical depression (i.e., depressed patients with unusual symptoms, e.g., hypersomnia, weight gain, and interpersonal rejection sensitivity fluoxetine, paroxetine, sertraline, and citalopram), anxiety disorders, panic disorder (sertraline and paroxetine), dysthymia, premenstrual syndrome, postpartum depression, dysphoria, bulimia nervosa (fluoxetine), obesity, borderline personality disorder, obsessive-compulsive disorder (fluvoxamine, fluoxetine, paroxetine, and sertraline), alcoholism, rheumatic pain, and migraine headache. Among the SSRIs, there are more similarities than differences however, the differences between the SSRIs could be clinically significant. 

Enhance serotonergic transmission through blocked reuptake at the synapse Indications Depression, panic and eating disorders, obsessive compulsion, premenstrual dysphoria, posttraumatic stress and bipolar disorders, alcohol dependence, premature ejaculation, diabetic neuropathy Common drug examples ... 

Steiner M, Lamont J, Steinberg S, Stewart D, Reid R, Streiner D. Effect of fluoxetine on menstrual cycle length in women with premenstrual dysphoria. Obstet. Gynecol 1997 90(4) 590-595. 

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