Project Summary

Cynthia Neill Epperson, M.D. (Independent Investigator 2005) of Yale University School of Medicine, plans to use neuroimaging to better understand how the antidepressant Prozac/Sarafem may mediate its benefit in some women who have premenstrual dysphoric disorder (PMDD). PMDD, which occurs in up to 9 percent of menstruating women, is characterized by debilitating mood symptoms such as irritability, anxiety/tension, depression and mood fluctuations. PMDD’s causes are unknown, but hormones and neurochemical interactions in the brain most likely are responsible. Using proton magnetic resonance spectroscopy (PMRS), Dr. Epperson has found that neurochemical GABA levels fluctuate across the menstrual cycle in healthy women and those with PMDD, but women with PMDD have fluctuations “out of sync” with normal hormonal changes. Preliminary data show Prozac/Sarafem corrects the abnormal GABA fluctuations through increased production of the hormone allopregnanolone. In the proposed study, Dr. Epperson aims to use PMRS in 16 women to study whether the antidepressant mediates its effect by modulating serotonin or through allopregnanolone, and therefore indirect modulation of GABA. Findings should lead to a better awareness of the role of hormones and neurochemicals in PMDD.

Program Area: OTHER\Premenstrual Dysphoric Disorder

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