For PMS that disrupts quality of life, which pharmacologic treatment may benefit?

• A. An opioid analgesic
• B. A calcium channel blocker
• C. A monoamine oxidase inhibitor (MAOI)
• D. A selective serotonin reuptake inhibitor (SSRI)

Answer: (D)

SSRIs are effective for PMS with mood-related disruption because they directly target the mood symptoms that often drive quality-of-life impairment in this condition. By increasing serotonin availability in brain circuits that regulate mood, anxiety, and irritability, these medications help reduce the emotional symptoms that occur in the luteal phase. They can be taken continuously or only during the luteal phase, offering flexible options that fit the patient’s symptom pattern. Other choices don’t address these mood disturbances as effectively: opioids focus on pain relief and carry dependence risks; calcium channel blockers are for cardiovascular issues and don’t treat mood symptoms; MAO inhibitors have complex dietary and drug interactions and are not preferred for PMS.