Premenstrual dysphoric disorder PMDD

Premenstrual syndrome (PMS) is a constellation of symptoms including mild mood disturbance and physical symptoms that occur prior to menses and resolve with initiation of menses. It is estimated that up to 70% of menstruating women experience symptoms of PMS. However, a spectrum of premenstrual mood disturbances exists and the most severe is premenstrual dysphoric disorder (PMDD). Approximately 4% to 7% of women have PMDD. A summary of the American Psychiatric Association s criteria for PMDD is as follows1,21 ... 

Premenstrual dysphoric disorder (PMDD) Fluoxetine Sarafem only), paroxetine (controlled-release), sertraline. 

The selective serotonin reuptake inhibitors (SSRI) have been used in adults for a wide variety of disorders, including major depression, social anxiety (social phobia), generalized anxiety disorder (GAD), eating disorders, premenstrual dysphoric disorder (PMDD), post-traumatic stress disorder (PTSD), panic, obsessive-compulsive disorder (OCD), trichotillomania, and migraine headaches. Some of the specific SSRI agents have an approved indication in adults for some of these disorders, as reviewed later in this chapter. The SSRIs have also been tried in children and in adults for symptomatic treatment of pain syndromes, aggressive or irritable ( short fuse ) behavior, and for self-injurious and repetitive behaviors. This chapter will review general aspects of the SSRIs and discuss their approved indications in children and adolescents. 

In four instances, the agency has invoked this rule at the time of approval of supplements for new indications for psychotropic drugs already approved for other psychiatric indications. It was noted in the approval letters for these supplements that, since the drugs in question would likely be used in children and/ or adolescents with the newly approved indications, the FDA required the sponsors of these products to conduct studies that would be pertinent to such use in the pediatric population. Since the products were ready for approval in adults, the FDA deferred the required pediatric studies to a future date. Alternatively, sponsors could make an argument for waiver of the requirement. The drug products and indications for which the FDA has required studies under the Pediatric Rule are as follows paroxetine for social anxiety disorder sertraline for post-traumatic stress disorder (PTSD) olanzapine for acute mania in bipolar disorder and fluoxetine in premenstrual dysphoric disorder (PMDD). 

A related issue is premenstrual dysphoric disorder (PMDD), which affects 3% to 8% of women in their reproductive years. Unlike the much milder and more prevalent premenstrual syndrome (PMS), PMDD is characterized by the following symptoms ... 

Some of the growth in antidepressant use may be related to the broad application of these agents for conditions other than major depression. For example, antidepressants have received FDA approvals for the treatment of panic disorder, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). In addition, antidepressants are commonly used to treat pain disorders such as neuropathic pain and the pain associated with fibromyalgia. Some antidepressants are used for treating premenstrual dysphoric disorder (PMDD), mitigating the vasomotor symptoms of menopause, and treating stress urinary incontinence. Thus, antidepressants have a broad... 

Fluoxetine hydrochloride is most recognized as an antidepressant, but it is also used to relieve symptoms of premenstrual dysphoric disorder (PMDD) (premenstrual syndrome). These symptoms include mood swings, tension, bloating, irritability, and breast tenderness. Eh Lilly began marketing fluoxetine hydrochloride as Sarafem in 2000 for treating PMDD. 

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... 

Sertraline hydrochloride is used in the management of depression, obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), and social anxiety disorder. 

Premenstrual syndrome (PMS), as its name implies, is a constellation of symptoms which recur at monthly intervals during the seven to 10 days before the onset of menstrual bleeding and abate shortly after menstruation starts. The symptoms can be psychological, such as lowering of mood and irritability somatic, such as breast tenderness, feelings of bloatedness and signs of fluid retention behavioural, such as changes in food consumption and in appetite. If the symptoms are severe, the condition may qualify for the DSM-IV label of Premenstrual Dysphoric Disorder (PMDD). PMDD occurs in some 5% of normal women. 

The term premenstrual dysphoric disorder (PMDD) describes a condition with more severe symptoms, which can cause major disruption to life and relationships. 

Approximately 90% of women experience symptoms of premenstrual syndrome (PMS), and more than 80% of women report that psychological and physical symptoms worsen during the perimenopause phase. Up to 3% to 5% of menstruating women experience severe mood and anxiety symptoms and meet criteria for the diagnosis of premenstrual dysphoric disorder (PMDD). 

Premenstrual dysphoric disorder (PMDD)—A severe form of premenstrual syndrome and is listed in the appendix of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Revised. The diagnostic criteria require prospective documentation of symptoms, a specific constellation of symptoms, and functional impairment. 

Controlled release only is used for premenstrual dysphoric disorder (PMDD), as defined in the DSM-IV. 

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