Lanza di Scalea Teresa, Pearlstein Teri
Department of Psychiatry, Rhode Island Hospital and Miriam Hospital, 593 Eddy Street, Providence, RI 02903, USA.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Women's Behavioral Medicine, Women's Medicine Collaborative, Miriam Hospital, 146 West River Street, Providence, RI 02904, USA.
Psychiatr Clin North Am. 2017 Jun;40(2):201-216. doi: 10.1016/j.psc.2017.01.002. Epub 2017 Mar 1.
Premenstrual dysphoric disorder (PMDD) comprises emotional and physical symptoms and functional impairment that lie on the severe end of the continuum of premenstrual symptoms. Women with PMDD have a differential response to normal hormonal fluctuations. This susceptibility may involve the serotonin system, altered sensitivity of the GABA receptor to the neurosteroid allopregnanalone, and altered brain circuitry involving emotional and cognitive functions. Serotonin reuptake inhibitors are considered the first-line treatment. Second-line treatments include oral contraceptives containing drospirenone, other ovulation suppression methods, calcium, chasteberry, and cognitive-behavioral therapy.
经前烦躁障碍（PMDD）包括情绪和身体症状以及功能损害，这些症状处于经前症状连续体的严重一端。患有PMDD的女性对正常的激素波动有不同的反应。这种易感性可能涉及血清素系统、γ-氨基丁酸（GABA）受体对神经甾体别孕烷醇酮的敏感性改变，以及涉及情绪和认知功能的脑回路改变。血清素再摄取抑制剂被认为是一线治疗方法。二线治疗包括含有屈螺酮的口服避孕药、其他抑制排卵的方法、钙、贞节果以及认知行为疗法。
