Your doctor may prescribe one or more medications for premenstrual syndrome. The success of medications in relieving symptoms varies from woman to woman. Commonly prescribed medications for premenstrual syndrome include:
• Antidepressants. Selective serotonin reuptake inhibitors (SSRIs), which include fluoxetine (Prozac, Sarafem), paroxetine (Paxil), sertraline (Zoloft) and others, have been successful in reducing symptoms such as fatigue, food cravings and sleep problems and are the first line agents for treatment of severe PMS or PMDD. These drugs are generally taken daily. But for some women with PMS, use of antidepressants may be limited to the two weeks before menstruation begins.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). Taken before or at the onset of your period, NSAIDs such as ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve) can ease cramping and breast discomfort.
• Diuretics. When exercise and limiting salt intake aren't enough to reduce the weight gain, swelling and bloating of PMS, taking diuretics, or water pills, can help your body shed excess water through your kidneys. Spironolactone (Aldactone) is a diuretic that can help ease some of the symptoms of PMS.
• Oral contraceptives. These prescription medications stop ovulation and stabilize hormonal swings, thereby offering relief from PMS symptoms. Yaz, a type of birth control pill containing the progestin drospirenone, which acts similarly to the diuretic spironolactone, has been shown to be even more effective than regular birth control pills are in reducing the physical and emotional symptoms of PMS and PMDD.
• 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.