Psychiatry Investigation  2014;11(1):95-101

Low-Dose Acetazolamide in the Treatment of Premenstrual Dysphoric Disorder: A Case Series.

Gabriele SANI 1 2 ; 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

Affiliations

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Keywords

Premenstrual dysphoric disorder; Sulfonamide diuretics; Acetazolamide; GABA transmission

Country

Republic of Korea

Language

English

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.