ARTICLESA Comprehensive Review of Treatment Options for Premenstrual Syndrome and Premenstrual Dysphoric DisorderMAHARAJ, SHALINI MPAS; TREVINO, KENNETH PhD Author Information MAHARAJ: Department of Physician Assistant Studies, University of Texas Southwestern Medical Center, Dallas, TX TREVINO: Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX K.T. has received research grant support funding (T32 MH67543-08) from the National Institute of Mental Health that was used in part to support this review. S.M. declares no conflicts of interest. Please send correspondence to: Kenneth Trevino, PhD, Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75235-8898 (e-mail: [email protected]). Journal of Psychiatric Practice: September 2015 - Volume 21 - Issue 5 - p 334-350 doi: 10.1097/PRA.0000000000000099 Buy Metrics Abstract Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome that involves a combination of emotional and physical symptoms that result in significant functional impairment. Because of the debilitating nature of PMDD, multiple treatment options have been considered. This review provides a comprehensive overview of these therapeutic regimens to help health care professionals provide adequate treatment for PMDD and premenstrual syndrome. The treatments that are reviewed are organized into the following categories: psychiatric, anovulatory, supplements, herbal, nonpharmacological, and other. Selective serotonin reuptake inhibitors have been established as the first-line treatment for PMDD. Although luteal phase or continuous dosing can be used, additional research is needed to more thoroughly compare the efficacies and differential symptom response of continuous, semi-intermittent, luteal phase, and symptoms-onset dosing. The psychiatric medications venlafaxine, duloxetine, alprazolam, and buspirone have also been found to be useful treatments for PMDD. Various anovulatory-related treatments have demonstrated efficacy; however, the use of some of these treatments remains limited due to potential side effects and/or the availability of cheaper alternatives. Although a variety of supplement and herbal-related treatments have been proposed, with some warranting further research, at this time only calcium supplementation has demonstrated a consistent therapeutic benefit. In conclusion, serotoninergic antidepressants have been established as the first-line treatment option for PMDD; however, there are a variety of additional treatment options that should be considered if a patient fails to achieve an adequate therapeutic response with a selective serotonin reuptake inhibitor. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.