Premenstrual Dysphoric Disorder (PMDD) is a uniquely interesting psychiatric disorder, about which most psychiatrists know little. It’s important both because it is chronic and disruptive for sufferers but also because it gives us clues to the underlying pathophysiology of affective disorders more generally.
Nov 20, 2023·edited Nov 20, 2023Liked by Thomas Reilly
The interaction between progesterone and catatonia is also very interesting. There was once a patent application to use RU486 in catatonia, but as far as I know it never went anywhere.
Oestrogen also seems to modulate ADHD symptoms -
Roberts B, Eisenlohr-Moul T, Martel MM. Reproductive steroids and ADHD symptoms across the menstrual cycle. Psychoneuroendocrinology. 2018 Feb;88:105-114.
Baker AS, Freeman MP. Management of attention deficit hyperactivity disorder during pregnancy. Obstet Gynecol Clin North Am. 2018;45(3):495-509.
Hi Thomas, any thoughts on underlying psychopathology? Could it be related to ASD? I have a son with Asperger’s Disorder as it was called when he was diagnosed and share some traits. My PPDD includes alcohol abuse, I want to drink and when I do I drink a lot. Don’t want to drink rest of the month, but always that few days before. When I was taking Zoloft I also had a much higher desire to drink daily. I also get a rebound high sex drive at onset of menstruation (when I make up with my partner after being horrible). Also when I stopped breastfeeding I got anxiety and depression, after both my children but worse with first one, I couldn’t drive the car at all, it was weird.
There’s been some research into how alcohol affects the menstrual cycle and also how consumption of alcohol varies across the cycle - https://helloclue.com/articles/cycle-a-z/alcohol-cycle
I’m not aware of much research linking ASD and PMDD but it’s an interesting thought!
The interaction between progesterone and catatonia is also very interesting. There was once a patent application to use RU486 in catatonia, but as far as I know it never went anywhere.
Oestrogen also seems to modulate ADHD symptoms -
Roberts B, Eisenlohr-Moul T, Martel MM. Reproductive steroids and ADHD symptoms across the menstrual cycle. Psychoneuroendocrinology. 2018 Feb;88:105-114.
Baker AS, Freeman MP. Management of attention deficit hyperactivity disorder during pregnancy. Obstet Gynecol Clin North Am. 2018;45(3):495-509.
Thanks, this is really interesting.
Do you have any thoughts on why allopregnanolone failed in trials?
Hi Thomas, any thoughts on underlying psychopathology? Could it be related to ASD? I have a son with Asperger’s Disorder as it was called when he was diagnosed and share some traits. My PPDD includes alcohol abuse, I want to drink and when I do I drink a lot. Don’t want to drink rest of the month, but always that few days before. When I was taking Zoloft I also had a much higher desire to drink daily. I also get a rebound high sex drive at onset of menstruation (when I make up with my partner after being horrible). Also when I stopped breastfeeding I got anxiety and depression, after both my children but worse with first one, I couldn’t drive the car at all, it was weird.