The goals of this project are to detect and accurately describe menstrually-related mood disorders, explore their pathophysiology and response to pharmacological and environmental manipulation, and to document the relationship between reproductive endocrine change and disorders of mood as a way of further investigating the neurobiology of psychiatric illness. The longitudinal screening methods developed by this group are capable of distinguishing women with menstrually-related mood syndromes from those who only believe that they have such a syndrome. With these methods, we have identified the following: 1) an absence of diagnostic group differences in baseline and stimulated FSH and LH following GnRH stimulation in ten PMS patients and controls; 2) the absence of a consistent behavioral response to m-CPP in six patients with PMS compared with controls; 3) a significant decrease in red blood cell magnesium but not white blood cell or plasma magnesium in 27 patients with PMS compared with 20 controls; 4) preliminary evidence of the efficacy of fluoxetine in the treatment of premenstrual syndrome; 5) absence of a PMS diagnosis related difference in the five alpha and five beta metabolites of progesterone, allopregnanolone and pregnanolone; 6) the absence, on preliminary analysis, of PMS diagnosis related differences in vasopressin, atrial natriuretic factor, or ACTH; 7) an unequivocal therapeutic response to thyroid hormone supplementation in only one of 24 patients with premenstrual syndrome; 8) the failure of GnRH analogue (Lupron) to eliminate premenstrual syndrome in two of three patients studied so far.
