A Case of Kleptomania Correlating With Premenstrual Dysphoria

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Sir: Evidence suggesting efficacy of the serotonin reuptake inhibitors (SRIs) in the treatment of impulse-control disorders, ^1-3 including kleptomania^4,5 and premenstrual dysphoric disorder (PMDD),⁶ suggests that abnormal serotonin neurotransmission is implicated in their pathophysiology. If kleptomania is more common in women, although reporting bias clouds the data, then the periodic hormonal effects of estrogen on the serotonin system may be at play. We report on a patient with kleptomania and PMDD whose kleptomania symptoms varied consistently with the menstrual cycle, significantly worsening during the luteal phase. Treatment with escitalopram, 10 mg/day, for 4 weeks led to complete resolution of both kleptomania and PMDD symptoms.