A. Antidepressants. SSRIs such as fluoxetine (marketed as Sarafem for PMDD) is effective in reducing symptoms of PMDD. The dosage of fluoxetine (Sarafem) is 20 mg per day throughout the month. The dosage may be increased up to 60 mg per day if necessary. Sertraline (Zoloft) is also effective in treating PMDD. Sertraline should be started at 50 mg per day and increased up to 150 mg if necessary. These agents are often effective when given only during the luteal-phase.
B. Hormones. Estrogen, progesterone and triphasic oral contraceptives may improve symptoms of PMDD in some patients.
C. Spironolactone may improve physical symptoms such as bloating especially in combination with psychotropic medications such as the SSRIs.
E. Exercise. Moderate exercise can lead to improvement of physical and emotional symptoms of PMDD.
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