For a patient diagnosed with PMDD and minimal relief from non-prescription measures, which medication is the best choice?

Fluoxetine (Prozac) is the best choice for a patient diagnosed with Premenstrual Dysphoric Disorder (PMDD) who has not found adequate relief from non-prescription measures. Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) that has been shown to be effective in reducing the emotional and physical symptoms associated with PMDD. Clinical studies indicate that fluoxetine can help alleviate depression, irritability, and mood swings commonly experienced during the luteal phase of the menstrual cycle.

Given that PMDD is characterized by significant mood disturbances and emotional symptoms, the efficacy of fluoxetine in targeting serotonin dysregulation makes it a first-line treatment option for this condition. This psychotropic medication is particularly beneficial for patients who have persistent symptoms that interfere with their daily lives and do not improve with lifestyle modifications or over-the-counter treatments.

In contrast, the other options have limited or different roles in managing PMDD symptoms. Alprazolam, while effective for anxiety, does not specifically address the underlying mood disturbances of PMDD and can lead to dependency. Oral contraceptives may provide some relief for menstrual-related symptoms but are generally considered second-line treatments for PMDD and do not target the mood symptoms as effectively as SSRIs. Finally,