Psychiatry Investig.  2014 Jan;11(1):95-101.

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

• Sani G
• Kotzalidis GD
• Panaccione I
• Simonetti
• De Chiara
• Del Casale A
• Ambrosi E
• Napoletano F
• Janiri D
• Danese E
• Girardi N
• Rapinesi C
• Serata D
• Manfredi G
• Koukopoulos AE
• Angeletti
• Nicoletti
• Girardi P

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.

Keyword

Premenstrual dysphoric disorder; Sulfonamide diuretics; Acetazolamide; GABA transmission

MeSH Terms

Acetazolamide*
Anxiety Disorders
Carbonic Anhydrases
Comorbidity
Female
Follow-Up Studies
Humans
Mood Disorders
Acetazolamide
Carbonic Anhydrases