Selective Serotonin Reuptake Inhibitors or SSRIs have been shown to be effective for the treatment of premenstrual symptoms. These medications are not only useful for treating the irritability, depression and anxiety that occur during the 1-2 weeks before the menstrual period but may also help alleviate some of the physical symptoms of PMS.

Initially, SSRIs were prescribed for PMS every day of the month; however, recent studies indicate that intermittent dosing during the luteal phase may also be effective and may minimize the risk of side effects. Typically, treatment is initiated at day 14 of the cycle or at about the time of ovulation; it is then discontinued several days after the period starts. However, this strategy option may not work for everyone; for instance, women with an underlying depression who experience premenstrual worsening of mood do not respond as well to intermittent dosing. In this situation, and in other cases where intermittent dosing is ineffective, daily dosing of medication is recommended.

Ruta Nonacs, MD PhD

Freeman EW, Rickels K, Arredondo R et al. (1999), Full- or half-cycle treatment of severe premenstrual syndrome with a serotonergic antidepressant. J Clin Psychopharmacol 19(1):3-8.