The role of central serotonergic dysfunction in the aetiology of premenstrual dysphoric disorder - Therapeutic implications

Premenstrual dysphoric disorder (PMDD), as defined in DSM-IV, is a mood dis order. One of the leading theories for the pathogenesis of mood disorders i s dysfunction of the serotonergic system. An increasing database suggests t hat serotonergic dysfunction also characterises PMDD. Evidence that treatme nts which enhance serotonergic function are beneficial in reducing the symp toms of PMDD support this hypothesis. Indeed. most of the evidence from bas eline studies suggests predominantly a serotonergic rather than a noradrene rgic or dopaminergic dysfunction. Challenge studies further support this hy pothesis. These findings of neurotransmitter dysfunction are more consisten t than those of other neuroendocrine abnormalities for example. Based on tr eatment studies, a selective serotonin (5-hydroxytryptamine: 5-HT) reuptake inhibitor, fluoxetine, has been approved for use in PMDD by the US Food an d Drug Administration.