In this review, guidelines for the treatment of PMDD are provided.

Selective serotonin reuptake inhibitors (SSRIs) are the most widely used pharmacologic agents for treating depression and anxiety disorders, and several have also emerged as first-line treatment for premenstrual dysphoric disorder (PMDD). In numerous clinical trials, SSRIs have demonstrated efficacy in reducing the physical and behavioral symptoms of PMDD and improving social and occupational functioning.

SSRIs may be given either intermittently or continuously.

The authors described 3 dosing strategies for SSRI use — continuous dosing (daily throughout the month), intermittent (luteal phase only) dosing, and semi-intermittent dosing (continuous with increased dose in the luteal phase) — and reviewed the results of 2 placebo-controlled studies that compared the efficacy of these dosing strategies. They also described the candidates who would be best suited for each dosing strategy.

Steiner M, Pearlstein T, Cohen LS, et al. Expert Guidelines for the Treatment of Severe PMS, PMDD, and Comorbidities: the Role of SSRIs. J Womens Health (Larchmt) 2006;15:57-69.