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Low-Dose Acetazolamide in the Treatment of Premenstrual Dysphoric Disorder: A Case Series
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 대한신경정신의학회 2014 PSYCHIATRY INVESTIGATION Vol.11 No.1
The treatment of premenstrual dysphoric disorder (PMDD) is far from satisfactory, as there is a high proportion of patients who do notrespond to conventional treatment. The antidiuretic sulfonamide, acetazolamide, inhibits carbonic anhydrase and potentiates GABAergictransmission; 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 andone with an anxiety disorder, who were resistant to treatment and responded with symptom disappearance after being added-on 125mg/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. GABAergicmechanisms may be involved in counteracting PMDD symptoms.