Meeting abstract

https://doi.org/10.24869/spsih.2026.318

Intermittent Venlafaxine Treatment for Premenstrual Dysphoric Disorder

Elizabeth Nedić ; Department of Psychiatry, „Dr. Juraj Njavro“ National Memorial Hospital Vukovar, Županijska 35, 32000 Vukovar, Croatia *
Emio Halilović ; Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
Martina Rojnić Kuzman ; Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia; School of Medicine, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia

* Corresponding author.

Abstract

Introduction: Premenstrual dysphoric disorder
(PMDD) is the term for a set of psychophysical
symptoms that occur in about 5–8% of women before
the onset or during the first days of the menstrual
cycle. Symptoms include depressed mood,
anxiety, irritability, changes in appetite, lack of
energy, circadian rhythm disturbances, and physical
symptoms. Pathophysiologically, in PMDD
there is excessive sensitivity of affected individuals
to intense hormonal changes, which in cascade
fashion affect the serotonin system. The first-line
pharmacological treatment consists of selective
serotonin reuptake inhibitors (SSRIs). Antidepressant
therapy is introduced intermittently (in the
second half of the cycle) or continuously. Given
that antidepressants generally require at least one to two weeks to achieve an effect on improving
mental state, in theory, intermittent treatment of
PMDD could also be carried out only in the first
half of the cycle. A literature search did not identify
any studies in which an antidepressant was
prescribed in the first phase of the cycle for PMDD
symptoms. Case report: A 33-year-old patient,
unmarried, without children, has an unspecified
non-organic psychosis and has been in psychiatric
treatment since 2016. During regular check-ups,
she repeatedly complained of a worsening of her
mental state exclusively in the premenstrual period.
In addition to her regular therapy, an increased
dose of venlafaxine was introduced according to
the following schedule: 1.5 tablets of 37.5 mg (a
total of 56.25 mg) from day 1 to day 15 of the cycle,
and 1 tablet (37.5 mg) from day 16 to day 30
of the cycle. The patient responded favorably to
the addition of the antidepressant, experienced
no side effects, and continued to take venlafaxine
according to the recommended regimen. The status
of PMDD symptoms was objectified using the
DSRP (Daily Record of Severity of Problems) scale.
Conclusion: According to current guidelines, antidepressant
therapy for PMDD is introduced in
the second half of the menstrual cycle, whereas in
this report the antidepressant (venlafaxine) was
introduced in the first half of the menstrual cycle.
In this patient, a favorable outcome of this intermittent
dosing on PMDD symptoms was achieved.

Keywords

venlafaxine; PMDD; premenstrual dysphoric disorder

Hrčak ID:

353013

URI

https://hrcak.srce.hr/353013

Publication date:

15.6.2026.

Article data in other languages: croatian

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