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by Dr. Daniel J. Heller
Should you take an antidepressant for PMDD only after you ovulate? We explain below why this idea either makes no sense, or means everything we’ve been told for years about how SSRIs and antidepressants work is just plain wrong.
Many of our readers have asked us if they should take an antidepressant only in the two weeks before their period, rather than all month long. Of course, this is a question that should be taken up with your doctor. However, we checked the medical literature on this subject, and the research tends to agree that taking an antidepressant all month long works better than only taking the medication in the two weeks before your period (beginning at ovulation).
While it is an interesting idea that SSRIs like Sarafem® or Prozac® or Zoloft® could be taken solely in the two weeks after ovulation, it doesn’t make sense. Either that, or if it works, the whole psychopharmcology field, including psychiatrists and drug companies and all doctors who prescribe antidepressants need to hit the books, quick. That’s because for years we’ve been told that SSRIs specifically, and antidepressants in general, take weeks or even months to have their effect. And no one in the field of women’s medicine or gynecology has proposed that SSRIs have a different mechanism of action in PMDD compared to in depression or anxiety.
Why, then, would SSRIs work within ten days or so in PMDD, but need much longer in other conditions? It just doesn’t make sense.
Of course, we’re not big believers in drugs, whether they’re antidepressants or birth control hormones, for PMDD or PMS. We understand that they’re lifesavers for some women. But we hear from thousands of women that they didn’t work, or had terrible side effects, or that they just plain don’t trust them. And the deep history of SSRIs is fraught with bad science, drug company influence, and medical doctors who haven’t maintained their ethical standards.
There are alternatives to antidepressants and prescription medications for PMDD and PMS. This whole website, as well as our product offerings, are devoted to telling interested women about these facts. You can find out about a host of natural solutions to premenstrual suffering right here.
Here’s a teaser: St. John’s Wort may be effective for PMDD and PMS, but wouldn’t work only two weeks per month, for the same reasons as we’ve discussed above for SSRIs. You will need to take it all month long.
Vitex Chastetree, on the other hand—including our proprietary, doctor-designed PMS Comfort Herbal—may be effective if taken only in the two weeks before your period. This is because, unlike St. John’s Wort and SSRIs, Vitex is believed to work by helping to balance your hormones. Since the worst part of PMS and PMDD hormone imbalance takes place in the two weeks after you ovulate, it’s possible that this could work for you, especially if your symptoms are mild, or only occur for a couple of days before your period. In practice, however, we usually recommend they be taken all month long, because the hormonal balances associated with PMDD and PMS truly exist throughout the month, not just before your period; and because many of our readers, and most of our customers, are dealing with severe symptoms that have a big impact on their lives and their relationships, and taking the herbs only for two weeks per month probably won’t be enough.