Low-dose acetazolamide in the treatment of premenstrual dysphoric disorder: A case series

Gabriele Sani, Georgios D. Kotzalidis, Isabella Panaccione, Alessio Simonetti, Lavinia De Chiara, Antonio Del Casale, Elisa Ambrosi, Flavia Napoletano, Delfina Janiri, Emanuela Danese, Nicoletta Girardi, Chiara Rapinesi, Daniele Serata, Giovanni Manfredi, Alexia E. Koukopoulos, Gloria Angeletti, Ferdinando Nicoletti, Paolo Girardi

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)95-101
Number of pages7
JournalPsychiatry Investigation
Issue number1
Publication statusPublished - Jan 2014


  • Acetazolamide
  • GABA transmission
  • Premenstrual dysphoric disorder
  • Sulfonamide diuretics

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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