Lithium in the Treatment of Premenstrual Dysphoric Disorder: A Case Report

Premenstrual dysphoric disorder (PDD) is characterized by mental, physical and cognitive symptoms that occurs in the late luteal phase of the menstrual cycle and regresses in the week following menstruation. In PDD, serotonin reuptake inhibitors and combined contraceptives are the primary pharmacologic treatments. In cases where there is a personal or family history of bipolar disorder (BD), the use of antidepressants may pose a risk of inducing manic episodes. The frequent coexistence of BD and PDD, the fact that both diseases are cyclic in nature and that common mechanisms such as hormonal changes play a role in their aetiologies, suggest that lithium might be efficacious in the treatment of PDD. Here, we present a case who didn't have a BD but a family history of BD and was treated with lithium monotherapy for PDD with a successful outcome. In cases where first- and second-line therapies cannot be used or no response is obtained in PDD patients, pharmacological agents that have demonstrated efficacy in preventing mood episodes among first-degree relatives, may present a viable solution.