The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your healthcare provider if you need to take any special precautions. Use each of these medications as recommended by your healthcare provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider.
If your PMS symptoms do not improve after two or three months of lifestyle changes, your healthcare provider may recommend drug therapy. The following drugs may be used to treat PMS symptoms:
***Please note FDA Public Health Advisory for Antidepressants:
The FDA advises that people taking antidepressants should be closely observed. For some, the medications have been linked to worsening symptoms and suicidal thoughts. These adverse effects are most common in young adults. The effects tend to occur at the beginning of treatment or when there is an increase or decrease in the dose.
Although the warning is for all antidepressants, of most concern are the SSRI class such as:
Serotonin reuptake inhibitors (SSRIs) affect the concentration of the neurotransmitter serotonin in the brain. These medications are used in the treatment of premenstrual dysphoric disorder (PMDD), a rarer and much more severe form of PMS. The medication can help relieve depression, irritability, and some of the physical symptoms. SSRIs may also offer benefit to women who have severe PMS, but are not diagnosed with PMDD.*¹
SSRIs tend to work much faster in relieving depressive symptoms associated with PMS than they do when faced with major depression. Depending on your condition, you may only need to take SSRIs during the two-week premenstrual period.
Benzodiazepines may be helpful if you have severe premenstrual anxiety that is not relieved by SSRIs or other treatments. These drugs must be used judiciously because they can cause dependency if used on a regular basis for three months or more. It may be best to use these drugs only a few days a month when symptoms are most severe.
Possible side effects include:
Hormonal contraceptives suppress ovulation and perhaps thereby, can provide relief of PMS in many women. Depending on your medical history and risk factors, your healthcare provider may prescribe combined oral contraceptive pills (which contain both estrogen and progestin) or a progestin-only contraceptive.
Possible side effects include:
Unpredictable spotting (usually resolves after first 3 cycles)
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) may be effective for pain relief during PMS by blocking prostaglandins, which are substances that cause inflammation. NSAIDs should be used on a short-term basis and in the lowest effective dosages. With the exception of the COX-2s, many are available in both prescription and a lower dose, nonprescription form ( ie, over-the-counter strength). They should be taken with food to minimize stomach irritation and upset.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a