Alternative Treatments for Premenstrual Dysphoric Disorder

Inclusion Criteria: * Age: 18-45 years. * Women with regular ovulatory menstrual cycles 26-32 days in length (for at least the previous six months). * A history of a depressive (but not bipolar) mood disorder, but not an ongoing episode (symptom free for the last 12 months). * Patients must meet DSM-IV criteria for Premenstrual Dysphoric Disorder (that includes irritability). * Objective ratings: mean HRSD \< 7 for follicular phase (day 5-10 of cycle after menses); mean HRSD \> 14 for premenstrual (luteal) phase (6 days prior to onset of menses onward). * Subjective ratings: mean Beck Depression Inventory \< 5 follicular phase; \> 10 premenstrual (luteal) phase, or * Daily ratings: minimal symptoms (mean less than 50 on 100mm scale) follicular phase; at least a 30% increase in mean affective symptom ratings, premenstrual (luteal) phase. * By clinical assessment and ratings, the patient has reported a history (for at least the last six months) of recurrent, moderate to severe premenstrual mood symptoms that impair some aspect of social or occupational functioning and that remit within a few days after the onset of menses. This pattern is prospectively documented with subjective and objective ratings over a 2-3 month interval. Patients must demonstrate a consistency of symptoms and a long enough duration of symptoms (7-10 days) to allow for study. * Subjects willing to endure the rigors of a long-term (up to 6 months) research study. Exclusion Criteria: * Subjects with signi…