Article October 31, 2000

Non-Antidepressant Treatment of Premenstrual Syndrome

Teri Pearlstein, MD; Meir Steiner, MD, PhD, FRCPC

J Clin Psychiatry 2000;61(suppl 12):22-27

Article Abstract

Although selective serotonin reuptake inhibitors are considered the first-line treatment option forpremenstrual syndrome, several other such options are also available. Multiple studies have indicatedthat medications that suppress ovulation alleviate premenstrual emotional and physical symptoms.However, the use of such medications, such as the gonadotropin-releasing hormone agonists, leads toprolonged low estrogen levels and cardiac and osteoporotic health risks. A recent double-blind, placebo-controlledstudy of 466 women with premenstrual syndrome reported that calcium was effective inreducing emotional, behavioral, and physical premenstrual symptoms. Recent preliminary trials havesuggested efficacy for cognitive therapy, light therapy, and tryptophan. Future studies of diet recommendations,exercise, relaxation, magnesium, nonsteroidal anti-inflammatory drugs, diuretics, opiateantagonists, and alternative therapies are needed.