Medicine 3: Quetiapine
Please consult a doctor to get medical prescription before administering the solutions.
What is it?
Quetiapine is an atypical antipsychotic, primarily used to treat mood disorders, such as bipolar disorder and schizophrenia. While it’s not a first-line treatment for PMDD, some clinicians may prescribe low-dose quetiapine off-label when symptoms are especially severe or resistant to standard treatments like SSRIs or SNRIs.
It is also sometimes used in combination with antidepressants, SSRIs or SNRIs (when first-line treatments fail) for added impact during the luteal phase of your menstrual cycle. Quetiapine is commonly sold under the brand name Seroquel.
How does it work?
Quetiapine affects multiple neurotransmitter systems in the brain, including dopamine and serotonin, both of which play key roles in mood regulation. Its mood-stabilizing effects help manage mood lability, anxiety, and irritability — common emotional symptoms of PMDD.
Unlike traditional antipsychotics, quetiapine has sedative and calming properties at low doses, which can be helpful for those struggling with insomnia or agitation in the premenstrual phase.
Small-scale studies have shown that quetiapine can improve PMDD symptoms (like mood lability, anxiety, and irritability) during the luteal phase, particularly when other medications have failed to provide relief.
What is its efficacy?
While large-scale studies are limited, preliminary research and clinical experience suggest that quetiapine may be beneficial for treatment-resistant PMDD, especially in improving emotional regulation and reducing distress. Its use is often considered a last resort when SSRIs, SNRIs, and hormonal treatments have not been effective.
When used in in combination with other treatements like SSRIs, quetiapine has shown to bring reduced mood lability, anxiety, and irritability1.
What are its side effects?
Like all medications, quetiapine comes with risks, especially since it was not originally developed for PMDD. According to the NHS, some of the side effects include:
Short-term side effects: Drowsiness or sedation, dizziness, dry mouth, weight gain, constipation.
Long-term side effects: metabolic syndrome (weight gain, high blood sugar, cholesterol issues), movement disorders (like tremors or restlessness), hormonal disruptions (e.g., elevated prolactin levels).
Quetiapine should only be considered under the guidance of a psychiatrist familiar with PMDD.
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