Drug of choice in premenstrual syndrome -
Ans. is 'b' i.e., SSRI Premenstrual syndrome (PMS) or perimenstrual syndromeo It is a collection of emotional symptoms, with or without physical symptoms, related to a woman's menstrual cycle,o Most women are of child-bearing age (up to 85%)o Medical definitions of PMS are limited to a consistent pattern of emotional and physical symptoms occurring only during the luteal phase of the menstrual cycle that are of''sufficient severity to interfere with some aspects of life"o Under typical definitions, at least 5 of the following symptoms must be present at some point during the ten days immediately before the onset of menses, and must not be present for at least one week between the onset of menses and ovulation.Emotional and behavioural symptomso Tension or anxietyo Depressed moodo Crying spellso Mood swings and irritability or angero Appetite changes and food cravingso Trouble falling asleep (insomnia)o Social withdrawalo Poor concentrationPhysical signs and symptomso Joint or muscle paino Headacheo Fatigueo Weight gain related to fluid retentiono Abdominal bloatingo Breast tendernesso Acne flare-upso Constipation or diarrhoeaCauseso Cyclic changes in hormoneso Chemical changes in the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter),o Depressiono Stresso Poor eating habitsTreatmentConservativeo Elimination of caffeine from dieto Smoking cessationo Counselling & emotional supporto Dietary changeso Regular exerciseo Stress managemento Adequate sleepOvulation inhibitiono OCPs (esp. drospirenone containing)o GnRH agonistsMedicationso Antidepressants like Selective serotonin reuptake inhibitors (SSRIs), which include Fluoxetine, paroxetine, sertraline and others are the first-line agents for treatment of severe PMS or PMDD. TCAs can also b tried.o Nonsteroidal anti-inflammatory drugs (NSAIDs). Taken before or at the onset of your period, NSAIDs such as ibuprofen or naproxen can ease cramping and breast discomfort,o Diuretics. When exercise and limiting salt intake aren't enough to reduce the weight gain. Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS.o Medroxyprogesterone acetate (Depo-Provera). For severe PMS or PMDD, this injection can be used to temporarily stop ovulation. However, Depo-Provera may cause an increase in some of the same signs and symptoms experienced with PMS, such as increased appetite, weight gain, headache and depressed mood,o Evening primrose & pyridoxine for mastalgia.
Antipsychotics
SSRI
OCP
Depo progesterone
Disorders in Menstruation