Low-Dose Acetazolamide in the Treatment of Premenstrual Dysphoric Disorder: A Case Series
A 35-year-old, Caucasian, woman with two children of 9 and 8 years of age, with a cyclothymic temperament and without a DSM-IV-TR axis I diagnosis, had suffered since adolescence from PMDD, characterized by mood swings, severe irritability, desperate crying spells, hopelessness and inner tension during the days immediately preceding menstruation. The patient was psychotropic medication-naïve. PMDD was absent during pregnancies.\nThe patient filled-out the daily symptom diary for three consecutive months and reported the above-mentioned symptoms during the 10 days before menses (CGIs, 6). Acetazolamide 125 mg/day was added during the critical days. Right after the first month of treatment she no more experienced the usual symptomatology (CGIs, 1), and reported no side effect. When she suspended premenstrual treatment with acetazolamide for two months PMDD reappeared as before. PMDD resolved completely when treatment was initiated again. No side effects occurred. The patient has already completed 14 months with add-on acetazolamide and is fully asymptomatic (CGIs=1).