SSRIs (Selective Serotonin Reuptake Inhibitors), in particular fluoxetine, sertraline and paroxetine, as well as clomipramine, continue to be proven effective in women with PMDD who have failed conservative treatment. These interventions have demonstrated excellent efficacy with almost immediate relief and minimal side-effects. Recent investigations of SRIs have also demonstrated success at low doses. Most investigations now suggest that if efficacy has not been attained after several dosing increases, other treatment options should be considered.