Low-Dose Acetazolamide in the Treatment of Premenstrual Dysphoric Disorder: A Case Series |
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| Authors: | Gabriele Sani Georgios D. Kotzalidis Isabella Panaccione Alessio Simonetti Lavinia De Chiara Antonio Del Casale Elisa Ambrosi Flavia Napoletano Delfina Janiri Emanuela Danese Nicoletta Girardi Chiara Rapinesi Daniele Serata Giovanni Manfredi Alexia E. Koukopoulos Gloria Angeletti Ferdinando Nicoletti Paolo Girardi |
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| Affiliation: | 1.NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant''Andrea Hospital, Rome, Italy.;2.Centro Lucio Bini, Rome, Italy.;3.IRCSS NEUROMED, Pozzilli, Isernia, Italy.;4.Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University, School of Medicine and Psychology, Rome, Italy.;5.Clinica Neuropsichiatrica Villa Rosa, Suore Ospedaliere del Sacro Cuore di Gesù, Viterbo, Italy. |
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| Abstract: | 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. |
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| Keywords: | Premenstrual dysphoric disorder Sulfonamide diuretics Acetazolamide GABA transmission |
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