Low-Dose Acetazolamide in the Treatment of Premenstrual Dysphoric Disorder: A Case Series
A 32-year-old, Caucasian, nulliparous woman, with cyclothymic premorbid temperament and without a DSM-IV-TR axis I diagnosis, had suffered since adolescence from PMDD, characterized by severe irritability, mood swings, inner tension, desire of "being elsewhere", desperate crying during the days immediately preceding the menstruation. The patient was psychotropic medication-naïve.\nThe patient filled-out the daily symptom diary for three consecutive months and reported the above-mentioned symptoms during the premenstrual phase (CGIs, 6). Acetazolamide 125 mg/day was added during the critical days. Right after the first two months of treatment she no more experienced the usual symptomatology (CGIs, 1), and reported no side effect.\nAfter four months of treatment she stopped taking the medication and she re-experienced exactly the same PMDD syndrome as before. She resumed acetazolamide intake as scheduled before, and symptoms disappeared once more; after further nine months of treatment, the patients manifests no premenstrual symptoms (CGIs, 1).