While one of my mantras is that I continually say :” there are no magic bullets” but,in my experience, given cooperation between doctor and patient it is usually possible to achieve a good outcome for patients experiencing menstrual cycle related mood disorders.
Personally I do not prescribed antidepressants for PMS are PMDD but, if patients already are on them I will build treatment plan around the medicines which they are already taking.
At the core of this approach is an attention to detail which looks at: levels of oestrogen and progesterone at different parts of the menstrual cycle, calculation of free copper levels, awareness of zinc and magnesium, assessment of methylation chemistry, the gut micro biome, the patients brain chemistry, overall level of inflammation and digestive processes.
It is an approach which utilises both medical history, ongoing symptom monitoring and laboratory testing as three pillars of a detailed diagnostic approach which, in my experience, frequently gives excellent results. Personally I do not prescribe antidepressant for the purpose of treating PMS or PMDD but will happily work alongside your GP or psychiatrist to look at all the other factors which may be involved in menstrual cycle related mood disorders.