RT Journal
A1 Hartman EE, Daley J
T1 A 45-year-old woman with premenstrual dysphoric disorder, 1 year later
JF JAMA
JO JAMA
YR 1999
FD August 25
VO 282
IS 8
SP 770
OP 770
DO 10.1001/jama.282.8.770
UL http://dx.doi.org/10.1001/jama.282.8.770
AB 
At Obstetrics and Gynecology Grand Rounds in May 1998, Barbara L. Parry,
MD, discussed the diagnostic criteria for premenstrual dysphoric disorder
(PMDD), along with its relationship to other psychiatric disorders.1 Ms V, the patient, had disabling symptoms of mood swings,
irritability, and depression prior to her menses since menarche. Over the
years, physicians prescribed several medications and recommended dietary modifications,
vitamins, and exercise, none of which provided consistent relief. For 9 months
in 1996, Ms V took fluoxetine, which improved her symptoms of PMDD, but caused
troubling adverse effects so that she stopped taking the medication. Dr Parry
explained the importance of a careful medical history and stressed that any
underlying conditions be addressed before treating PMDD. For patients who
meet the criteria for PMDD after 2 consecutive cycles, Dr Parry recommended
counseling and other treatment strategies, such as stress reduction, vitamin
supplements, or medications including selective serotonin reuptake inhibitors,
hormones, and anxiolytics. For Ms V, Dr Parry suggested trying a selective
serotonin reuptake inhibitor other than fluoxetine, such as sertraline or
paroxetine, to diminish the symptoms of PMDD and possibly avoid the adverse
effects Ms V experienced with fluoxetine.