Premenstrual Syndrome - Therapy

(Page 2)

Highlights	Symptoms	Resources
Introduction	Diagnosis	References
Causes	Treatment	Resources
Risk Factors	Lifestyle Changes	References
Complications	Medications

General side effects of SSRIs may include nausea, drowsiness, headache, weight gain and sexual dysfunction. Antidepressants may increase the risk for suicidal thinking and behavior in young adults ages 18 - 24. This risk for “suicidality” generally occurs during the first few months of treatment.

[For more information, see In-Depth Report #8: Depression.]

Antianxiety Drugs

Antianxiety drugs (called anxiolytics) may be helpful for women with severe premenstrual anxiety that is not relieved by SSRIs or other treatments.

Benzodiazepines. The standard anxiolytics are the benzodiazepines, with alprazolam (Xanax, generic) most often used for PMS. Doctors, however, generally do not recommend these drugs for PMS-related anxiety. Dependence is a risk and can occur after as short a time as 3 months of use. (Using alprazolam for only a few days per month when symptoms are most severe reduces this risk.) Common side effects are daytime drowsiness and a hung-over feeling. Respiratory problems may be worsened. Benzodiazepines also increase appetite, particularly for fats. Overdose is very serious, although rarely fatal. Benzodiazepines are potentially dangerous when used in combination with alcohol.

text continues below

Buspirone.. Buspirone (BuSpar, generic) is an anti-anxiety drug that may help reduce premenstrual irritability. Unlike benzodiazepines, buspirone is not addictive. Buspirone also seems to have less pronounced side effects than benzodiazepines and no withdrawal effects, even when the drug is discontinued quickly. Common side effects include dizziness, drowsiness, and nausea. [For more information, see In-Depth Report #28: Anxiety.]

Hormone Therapies

Hormone therapies are used to interrupt the hormonal cycle that triggers premenstrual syndrome symptoms. One method to accomplish this is through birth control pills.

Birth Control Pills. Oral contraceptives (OCs), commonly called birth control pills or "the Pill", contain combinations of an estrogen (usually estradiol) and a progestin (the synthetic form of progesterone). Some women may experience worsening of PMS symptoms with oral contraceptives.