Premenstrual dysphoric disorder (PMDD)
- SSRIs are first-line pharmacotherapy
- Continuous or luteal-phase dosing both work
- Drospirenone-containing COC is another option
- CBT/exercise can be useful adjuncts
- Confirm cyclic symptom pattern prospectively
- Refractory severe disease may need ovarian suppression
Use at a glance
- SSRIs are first-line pharmacotherapy
Practical pearls
- Continuous or luteal-phase dosing both work
- Drospirenone-containing COC is another option
Other practical pearls
- CBT/exercise can be useful adjuncts
- Confirm cyclic symptom pattern prospectively
Escalation / refractory disease
- Refractory severe disease may need ovarian suppression
Self-check
- What pattern is confirmed prospectively for PMDD?
Cyclic symptom pattern prospectively. - What SSRI dosing schedules work for PMDD?
Continuous or luteal-phase.
Drugs used for this (4)
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