Figure II-12-4. PMS SymptomsManagement. Proven treatments include the following:
Selective serotonin reuptake inhibitors (SSRIs). Fluoxetine hydrochloride,
natural progesterone vaginal suppositories, medroxyprogesterone acetate,
spironolactone, and vitamin B6 (pyridoxine). All of these options have been
proposed for the treatment of PMS, but only fluoxetine, alprazolam, and
GnRH agonists have been shown in controlled, double-blind trials to be
superior to placebo for the more severe symptoms of PDD. Recently reported
double-blind trials of fluoxetine have shown reductions of 40–75% in
troublesome behavioral and emotional symptoms. Similar outcomes have
been reported for buspirone hydrochloride and meclofenamate sodium in
descriptive studies. SSRIs are the treatment of choice for emotional
symptoms of PMS.
Drospirenone/ethinyl estradiol (Yaz), with the unique progestin
drospirenone (DRSP), has been approved by the FDA for the treatment of