Anti-depressants don't really address hormones, and hormone levels are a big part of PMDD, so you might need hormone medications in addition to the anti-depressant. Also, it's extremely common for antidepressants to work only partially on depression, so that patients need a combination of meds to get maximum relief (whether or not they have PMDD in addition to depression). To make matters even more confusing, antidepressants are also used to treat disorders besides depression.
I'm on two antidepressants - one to improve sleep and one for pain. The doses are lower than usually used for depression. I'm also on birth control, primarily to regulate my periods and control my PMDD. Before the birth contril, hubby used to call me "werewolf" because of my meat cravings and nasty mood during TOM which hubby called "meat week" because of my meat cravings. He would say it wasn't safe for him to enter the apartment during meat week unless he threw burgers and chocolate through the doorway and waited to hear munching. He was exagerating of course (but sadly not by much).
Birth control helps considerably, dialing my symptoms down to a manageable level, closer to normal pms in severity. Simple and processed carbs magnify symptoms, so I have to be creative in finding low-carb ways to indulge my chocolate cravings (such as sugar free hot cocoa).
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