Pretreatment pattern of symptom expression in premenstrual dysphoric disorder

Pearlstein, Teri; Yonkers, Kimberly A.; Fayyad, Rana; Gillespie, John A.

doi:10.1016/j.jad.2004.10.004

Cited by 126 publications

(110 citation statements)

References 20 publications

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“…Emotional reactivity can be further subclassified into anxious, depressive, or aggressive components, depending on individual susceptibility (Angst et al 2001;Endicott et al 1999;Backstrom et al 2003a;Freeman 2003;Pearlstein et al 2005;Steiner et al 1999). Therefore, the present study employed a shock-paired plus maze paradigm to test emotional reactivity in response to an aversive stimulus to better compare with the most prevalent PMDD symptom.…”

Section: Discussionmentioning

confidence: 99%

“…Both the onset and the hormonal milieu associated with dysphoric symptoms is highly variable (Pearlstein et al 2005) in women with this disorder. However, cyclicity of steroid levels appears to be necessary for PMDD symptom onset, as drugs which prevent ovulation, and thus prevent the increase in circulating levels of P and THP, prevent PMDD symptoms (Schmidt et al 1998).…”

Section: Discussionmentioning

confidence: 99%

“…There are reports that mood changes can be observed late in the luteal phase (i.e., "premenstrual syndrome") when endogenous THP levels are declining (Rapkin et al 1997;Pearlstein et al 2005), suggesting that steroid withdrawal in the rat may have clinical relevance. However, a severe form of this disorder is classified in the DSM-IV as premenstrual dysphoric disorder (PMDD) (Angst et al 2001;Backstrom et al 2003a,b;Freeman 2003;Rapkin 2003).…”

Section: Introductionmentioning

confidence: 99%

“…PMDD has an onset early to midluteal phase, when P and THP levels are increased (Angst et al 2001). Dysphoric mood at this time can encompass anxiety (Yonkers 1997), irritability, aggression, depression, and emotional reactivity, suggesting a diverse array of symptoms (Angst et al 2001;Endicott et al 1999;Freeman 2003;Pearlstein et al 2005;Backstrom et al 2003a;Smith et al 2003b;Steiner et al 1999). …”

Section: Introductionmentioning

confidence: 99%

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Steroid withdrawal in the mouse results in anxiogenic effects of 3α,5β-THP: a possible model of premenstrual dysphoric disorder

et al. 2005

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Rationale-3α-OH-5α[β]-pregnan-20-one (THP) is a positive modulator of the GABA A receptor (GABAR), which underlies its reported anxiolytic effect. However, there are conditions such as premenstrual dysphoric disorder (PMDD) where increases in THP levels can be associated with adverse mood.Objectives-In order to test for conditions where THP might be anxiogenic, we developed a mouse model of THP withdrawal. Because δ-containing GABAR are highly sensitive to THP modulation, results were compared in wild-type and δ knockout mice.Methods-Finasteride, a 5α-reductase blocker, was administered for 3 days to female wild-type or δ knockout mice. Then, animals were tested in the elevated plus maze, following acute administration of THP, lorazepam, flumazenil, or 4,5,6,pyridin-3-ol (THIP), and results compared to vehicle-injected controls. CA1 hippocampal GABAR α4 subunit levels were assessed by Western blot.Results-After THP withdrawal, THP produced anxiogenic effects, decreasing open arm entries on the elevated plus maze, following a brief shock, in contrast to its expected anxiolytic effects. As we have shown in rats, THP withdrawal also resulted in increased expression of the α4 subunit in mouse CA1 hippocampus. As expected for increases in α4-containing GABAR, THP withdrawn mice were relatively insensitive to the benzodiazepine (BDZ) lorazepam and had atypical responses to the BDZ antagonist flumazenil when tested on the plus maze. In contrast, they showed a greater anxiolytic response to THIP, which has greater efficacy at α4βδ than other GABAR. Although THP Correspondence to: Sheryl S. Smith, Sheryl.smith@downstate.edu. NIH Public AccessAuthor Manuscript Psychopharmacology (Berl) withdrawal in δ knockout mice also increased the α4 GABAR subunit, the anxiogenic effects of THP and the anxiolytic effects of THIP were not observed, implicating α4βδ GABAR in these effects.Conclusions-Based on these behavioral and pharmacological findings, we suggest that THP withdrawal in the mouse may serve as a rodent model of PMDD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Steroid withdrawal in the mouse results in anxiogenic effects of 3α,5β-THP: a possible model of premenstrual dysphoric disorder

et al. 2005

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“…Symptoms usually worsen one week before and peak two days before menstruation onset. A symptom-free period generally appears before ovulation [7].…”

Section: Premenstrual Disorders: Definition and Epidemiologymentioning

confidence: 99%

Interdisciplinary consensus on management of premenstrual disorders in Switzerland

Stute

Bodmer

Ehlert³

et al. 2017

Gynecological Endocrinology

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Premenstrual disorders (PMD) can affect women throughout their entire reproductive years. In 2016, an interdisciplinary expert meeting of general gynecologists, gynecological endocrinologists, psychiatrists and psychologists from Switzerland was held to provide an interdisciplinary algorithm on PMD management taking reproductive stages into account. The Swiss PMD algorithm differentiates between primary and secondary PMD care providers incorporating different levels of diagnostic and treatment. Treatment options include cognitive behavioral therapy, alternative therapy, antidepressants, ovulation suppression and diuretics. Treatment choice depends on prevalent PMD symptoms, (reproductive) age, family planning, cardiovascular risk factors, comorbidities, comedication and the woman's preference. Regular follow-ups are mandatory.

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Symptom-Onset Dosing of Sertraline for the Treatment of Premenstrual Dysphoric Disorder

et al. 2015

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Pretreatment pattern of symptom expression in premenstrual dysphoric disorder

Cited by 126 publications

References 20 publications

Steroid withdrawal in the mouse results in anxiogenic effects of 3α,5β-THP: a possible model of premenstrual dysphoric disorder

Steroid withdrawal in the mouse results in anxiogenic effects of 3α,5β-THP: a possible model of premenstrual dysphoric disorder

Interdisciplinary consensus on management of premenstrual disorders in Switzerland

Symptom-Onset Dosing of Sertraline for the Treatment of Premenstrual Dysphoric Disorder

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