|Gabriele Sani1,2;Georgios D. Kotzalidis1;Isabella Panaccione1,3;Alessio Simonetti1,2;Lavinia De Chiara1,2;Antonio Del Casale1;Elisa Ambrosi1;Flavia Napoletano1,2;Delfina Janiri1;Emanuela Danese1;Nicoletta Girardi1;Chiara Rapinesi1;Daniele Serata1;Giovanni Manfredi1,2;Alexia E. Koukopoulos1,2;Gloria Angeletti1,2;Ferdinando Nicoletti3,4; and Paolo Girardi1,2,5;
1;NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome,
2;Centro Lucio Bini, Rome,
3;IRCSS NEUROMED, Pozzilli, Isernia,
4;Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University, School of Medicine and Psychology, Rome,
5;Clinica Neuropsichiatrica Villa Rosa, Suore Ospedaliere del Sacro Cuore di Gesù, Viterbo, Italy
The treatment of premenstrual dysphoric disorder (PMDD) is far from satisfactory, as there is a high proportion of patients who do not respond to conventional treatment. The antidiuretic sulfonamide, acetazolamide, inhibits carbonic anhydrase and potentiates GABAergic transmission; the latter is putatively involved in PMDD. We therefore tried acetazolamide in a series of women with intractable PMDD. Here, we describe a series of eight women diagnosed with DSM-IV-TR PMDD, five of whom had comorbidity with a mood disorder and one with an anxiety disorder, who were resistant to treatment and responded with symptom disappearance after being added-on 125 mg/day acetazolamide for 7-10 days prior to menses each month. Patients were free from premenstrual symptoms at the 12-month follow-up. We suggest that acetazolamide may be used to improve symptoms of PMDD in cases not responding to other treatments. GABAergic mechanisms may be involved in counteracting PMDD symptoms.
Premenstrual dysphoric disorder;Sulfonamide diuretics;Acetazolamide;GABA transmission.