title: Low-dose acetazolamide in the treatment of premenstrual dysphoric disorder: a case series.
abstract: The treatment of premenstrual dysphoric disorder (PMDD) is far from satisfactory, as there is a high proportion of patients who do not respond to conventional treatment. The antidiuretic sulfonamide, acetazolamide, inhibits carbonic anhydrase and potentiates GABAergic transmission; the latter is putatively involved in PMDD. We therefore tried acetazolamide in a series of women with intractable PMDD. Here, we describe a series of eight women diagnosed with DSM-IV-TR PMDD, five of whom had comorbidity with a mood disorder and one with an anxiety disorder, who were resistant to treatment and responded with symptom disappearance after being added-on 125 mg/day acetazolamide for 7-10 days prior to menses each month. Patients were free from premenstrual symptoms at the 12-month follow-up. We suggest that acetazolamide may be used to improve symptoms of PMDD in cases not responding to other treatments. GABAergic mechanisms may be involved in counteracting PMDD symptoms.
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy. ; Centro Lucio Bini, Rome, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Sani
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Kotzalidis
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy. ; IRCSS NEUROMED, Pozzilli, Isernia, Italy.
authors.forename: Isabella
authors.initials: I
authors.lastname: Panaccione
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy. ; Centro Lucio Bini, Rome, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Simonetti
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy. ; Centro Lucio Bini, Rome, Italy.
authors.forename: Lavinia
authors.initials: L
authors.lastname: De Chiara
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Casale
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Ambrosi
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy. ; Centro Lucio Bini, Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Napoletano
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Delfina
authors.initials: D
authors.lastname: Janiri
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Danese
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Girardi
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rapinesi
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Serata
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy. ; Centro Lucio Bini, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Manfredi
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy. ; Centro Lucio Bini, Rome, Italy.
authors.forename: Alexia E
authors.initials: AE
authors.lastname: Koukopoulos
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy. ; Centro Lucio Bini, Rome, Italy.
authors.forename: Gloria
authors.initials: G
authors.lastname: Angeletti
authors.affiliation: IRCSS NEUROMED, Pozzilli, Isernia, Italy. ; Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University, School of Medicine and Psychology, Rome, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Nicoletti
authors.affiliation: NESMOS Department (Neuroscience, Mental Health, and Sensory Organs), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy. ; Centro Lucio Bini, Rome, Italy. ; Clinica Neuropsichiatrica Villa Rosa, Suore Ospedaliere del Sacro Cuore di Gesù, Viterbo, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
keywords: Acetazolamide; GABA transmission; Premenstrual dysphoric disorder; Sulfonamide diuretics