Premenstrual dysphoric disorder effects

The current SSRIs in the United States inclnde fluoxetine, fluvoxamine, sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro). All effectively treat major depression. In addition, one or more of the SSRIs has been shown effective in the treatment of dysthymic disorder, the depressive phase of bipolar disorder, premenstrual dysphoric disorder, panic disorder, social phobia, obsessive-compnlsive disorder, bnlimia nervosa, and binge-eating disorder. 

In this text, the focus of our discussion is on the last issue. To illustrate the problem, we consider the effect of gender on drug pharmacokinetics (see Chapter 3, Chapter 5, Chapter 7, Chapter 10, and Chapter 12) and then address two important gender-related questions the use of medications during pregnancy and the drug treatment of premenstrual dysphoric disorder (see Chapter 14). 

Smith, S. S., Ruderman, Y., Frye, C., Homanics, G., and Yuan, M. (2006). Steroid withdrawal in the mouse results in anxiogenic effects of 3alpha,5beta-THP A possible model of premenstrual dysphoric disorder. Psychopharmacology (Berl) 186, 323—333. 

While Nemets et al. (2002) showed that 12 gm of oral inositol per day did not show any beneficial effects in premenstrual dysphoric disorder, 18 gms per day of inositol was therapeutic for patients suffering from bulimia nervosa and... 

Nemets, B., Talesnick, B., Belmaker, R.H., and Levine, J., 2002, Myoinositol has no beneficial effect on premenstrual dysphoric disorder. World J. Biol. Psychiatry 3 147-149. 

Decreased GABAergic effects have also been associated with depression. In vivo evidence of GABAergic dysfunction in patients with depression includes decreased levels of GABA in the CSF, plasma, and occipital cortex (45, 46). Premenstrual dysphoric disorder (PMDD), which is a condition of depressive symptoms prior to menstruation, has been associated with... 

The symptoms of premenstrual syndrome (PMS), also called premenstrual dysphoric disorder, include depressed mood, anxiety, affective lability, and anger or irritability.79 Since low serotonin levels are thought to be involved in the etiology of depression, aggression, and impulsivity,80 specific serotonin reuptake inhibitors have been tested in PMS. The SSRI fluoxetine was found to be better than placebo.81 Since chronic treatment with SSRIs can influence many neuron systems other than serotonin,82 Steinberg et al.83 designed a study using tryptophan, relatively specific for its effect on serotonin, on the effects of symptoms of PMS. In a randomized controlled clinical trial, 37... 

The diversity of action on brain chemistry provides evidence that St. John s wort can exercise a significant effect on a depressed person s brain. However, since most of these actions are not nearly as intense as those found in SSRIs and other antidepressants, it makes sense that St. John s wort cannot cure severe depression. Thus St. John s wort seems best suited for slight to moderate depression, anxiety, or stress. It has also been recognized as a possible cure for premenstrual dysphoric disorder. However, users should be cautioned that appropriate doses of St. John s wort are much more variable than those of standard antidepressants. 

Monoamine oxidase inhibitors, such as SSRIs, have been shown to be effective in the treatment of depression, and they have become among the most widely used prescription drugs in the United States. Prozac is used not only to treat major depressive disorders but also bulimia nervosa, obsessive-compulsive disorder, panic disorder, and premenstrual dysphoric disorder. Multiple serotonin receptor subtypes are involved. Specific serotonin receptor subtype agonists and antagonists have been radiolabeled with positron-emitting tracers to assess the state of the serotonergic system. 

---