1 A family history of depressive illness is common in women with PMS/PMDD.5 Women who seek treatment for premenstrual symptoms frequently have other emotional disorders, most commonly depressive disoders, substance abuse, or anxiety. Conversely, women who have mood disorders frequently experience http://www.selleckchem.com/products/Imatinib-Mesylate.html worsening of symptoms premenstrually.14 In spite of these observable similarities, increasing evidence suggests that PMS/PMDD is not a simple variant Inhibitors,research,lifescience,medical of depression, but a distinct disorder. While depressive

symptoms characterize a substantial number of women with selleck chem Pacritinib severe perimenstrual distress, there is also a sizeable group of women who do not suffer from either depression or anxiety symptoms, but experience severe or moderate perimenstrual distress with symptoms of irritability, nervousness, and tension.9 On the basis of epidemiologic Inhibitors,research,lifescience,medical findings, the researchers posited that the features of irritability and tension irrespective of the presence of depressive symptoms may form the core symptoms of the disorder, a premise also advanced by Eriksson, on the basis of results of antidepressant treatment studies.15,16 Data from epidemiologically based twin studies indicated that the degree to which premenstrual symptoms shared Inhibitors,research,lifescience,medical generic and environmental risk factors with major depression was modest, a possible indication that there

is no close etiologic relationship

between the Inhibitors,research,lifescience,medical two disorders.17 The evidence that severe PMS/PMDD responds much more robustly to serotonergic antidepressants than to other antidepressants that are clearly effective for depressive disorders suggests differences in underlying mechanisms. There is also empirical evidence that a good response of PMS/PMDD patients to serotonergic antidepressants is not. explained by depressive symptoms or a history of depression.18,19 The rapid response of several days rather than several weeks of PMS patients Inhibitors,research,lifescience,medical to selective serotonin reuptake inhibitors (SSRIs), the efficacy of SSRIs at low doses, and the efficacy of other serotonin agonists, including fenfluramine20 and buspirone,21 which are not effective for depression, all suggest that the underlying mechanisms of severe PMS/PMDD differ from other depressive disorders. Evaluation The diagnosis of premenstrual dysphoria, PMS, or PMDD is made primarily on Brefeldin_A the basis of the symptom pattern and the exclusion of other possible diagnoses. The essential elements are confirmation of the expected relationship of the symptoms to the menstrual cycle, ie, that the symptoms occur premenstrually and remit with menses; that the symptoms are distressing and warrant treatment, ie, that the symptoms impair usual functioning; and that the symptoms are not due to another physical or mental disorder.