Problem: 48-year-old woman presents with an unstable mood. She develops mood instability including sadness, irritability, anxiety, poor concentration, and insomnia approximately one week prior to the onset of menses. The symptoms continue until approximately two days after starting her menstrual period. The symptoms have been present for the past 18 months and have interfered with her relationships and work. She has no history of a psychotic, mood, or anxiety disorder. She does not smoke or drink alcohol. She does not use drugs. Of the following, which is first line in managing this patient's symptoms? A selective serotonin reuptake inhibitor Combined oral contraceptives Estrogen therapy Leuprolide acetate. Need Assignment Help?