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PMDD Medications

Prozac^®, Sarafem^®, and Zoloft^®: PMDD Medications and Drugs for PMS
by Dr. Daniel J. Heller

If you've been diagnosed with PMDD, or have been in a gynecologist's or psychiatrist's office lately, you've probably heard of Sarafem^®, the antidepressant medication that is used as PMDD medication and a drug for severe PMS. Sarafem^® is the exact same drug as Prozac^® (Fluoxetine^®), but relabeled with a more feminine name, and marketed to doctors and consumers for a different purpose: namely, treating PMDD and severe PMS rather than depression.

Common Antidepressant Medications:

Prozac^® is one of a class of antidepressant drugs called Selective Serotonin Reuptake Inhibitors, or SSRIs for short. Others drugs in this group have been used to treat PMDD and PMS, including: Zoloft^®, Paxil^®, Celexa^®, and Lexapro^®.

If you're wondering why antidepressants like Sarafem^® or Prozac^® are used to treat a hormonal problem like PMDD or PMS, it helps to understand that PMDD is caused by more than just hormones. Mood chemistry plays a big part in PMDD—so both hormones and mood chemistry can cause PMDD. It may be that hormones cause mood chemistry imbalances, or that mood chemistry problems can cause hormones to go awry, but in either case both antidepressants and hormonal birth control have the potential to control premenstrual symptoms. We'll have more to say later about the potential problems with drugs like Prozac^® for PMS and PMDD, and about how natural treatments are too often overlooked or dismissed. But current research shows that both physical and emotional symptoms are often helped by using SSRIs for PMDD and PMS.

Do Drugs Like Sarafem^® , Prozac^®, and Zoloft^® Really Work for
PMDD & PMS?

There is a legitimate concern that SSRIs may be no better than placebo (read more about SSRIs placebo below) for the treatment of depression, and PMDD symptoms are often remarkably similar to those of depression. On the other hand, there is also plenty of evidence showing that antidepressant drugs help many women with PMDD and PMS. But even then, some doctors and researchers feel that since the current drugs for PMDD do not help all women, or only give partial improvement, the current pharmacologic approaches are not enough.

Another potential problem with antidepressant drug treatment of PMDD is that doctors may prescribe antidepressant drugs for PMDD and PMS without taking the time to really understand their patients, and may not bother to help them learn about natural PMDD remedies that don't carry the same risk of side effects. Although SSRIs do often appear to help, we believe they shouldn't be considered the first and only potential solution, but all too often no other approach is considered. In our opinion—and that of many medical doctors and experts in the field—diet, nutritional supplementation, herbal supplementation, and lifestyle modification ought to be tried first, and might work just as well.

Why Antidepressant Side Effects Make Some Women Want Natural
PMDD Relief?

Every drug has the potential for side effects. While not all women experience side effects from PMDD medication, many women don't realize there is any alternative to medication for PMDD, so they suffer through bothersome and even severe medication side effects unnecessarily. Millions of other women are simply unable to tolerate the side effects of Sarafem^®, Prozac^®, Zoloft^®, Lexapro^®, and the other SSRIs, and are actively seeking natural PMDD alternatives.

There are Safe Natural Alternatives to Antidepressants
for PMDD and PMS Relief

Side effects from correctly selected and prepared herbal medicines and nutritional supplements are extremely rare. In the past few years, the United States Food and Drug Administration (FDA) has begun to more carefully enforce existing regulations on the manufacture of dietary supplements, so that excellent and strict quality control is now the rule.

Among the most common side effects of the SSRI antidepressants are:

Nausea

Dry mouth

Headache

Diarrhea

Nervousness, agitation or restlessness

Reduced sexual desire or difficulty reaching orgasm

Rash

Increased swelling

Weight gain

Drowsiness

Insomnia

Emotional blunting (not feeling highs or lows)

Unfortunately, many of these are quite similar to PMDD and PMS symptoms. When medication causes these symptoms, they're more likely to occur all month long rather than just premenstrually.

The best alternative to antidepressants for PMDD comes from an overall holistic approach that combines diet, lifestyle, safe herbal remedies, and nutritional supplements. In fact, these three natural approaches improve your chances of success regardless of whether you decide to try medication or a supplement program like PMS Comfort:

Counseling: counseling with either a licensed therapist or a pastoral counselor is proven to help relieve PMDD, and in fact the combination of counseling and medication works better than either alone. We all need someone to talk to, and PMDD symptoms can result in feeling misunderstood and confused.
Stress relief: stress causes PMDD, and PMDD causes stress. Learning to manage stress with techniques you can use everyday, and throughout the month, will decrease your premenstrual symptoms.
Exercise: this could probably be listed under stress relief. While exercise isn't a cure-all for PMDD—plenty of women with PMDD stay in great shape—it helps, and will help any treatment to work even better.

Controversy: Do SSRIs Work any Better than Placebo?

Do antidepressant drugs work any better than placebo, or sugar pill? Surprisingly enough, the answer is not a definite “yes.” This is a very important question, and it cuts to the core of the whole medical approach to treating depression, and PMDD. While many studies show that antidepressant medication for PMDD and drugs for PMS are effective, more and more women are becoming concerned by the controversy surrounding these drugs that has been featured on the front pages of influential news sources such as the Huffington Post, CBS News, and 60 Minutes.

A February 2012 60 Minutes segment featured an interview with the British medical doctor, Tim Kendall, who concluded that “for mild to moderate depression, these drugs probably aren't worth having” in the British Health System formulary. Many other doctors and researchers have reached the same conclusion, including Harvard professor, Irving Kirsch, who has written a book exposing unresolved questions in the research used to support the use of SSRIs.

This controversy is engaging experts at the highest level of the medical field. A former editor of the prestigious New England Journal of Medicine, in a highly publicized book review, did not rule out the idea that, for depression,"psychoactive drugs are useless … or worse than useless."

PMDD and Antidepressants: To Medicate, or not to Medicate

Your decision about how to address your PMDD symptoms may not be an easy one. You may have white-knuckled it through days and nights of premenstrual misery, troubled relationships, and unpredictable moods, all thanks to a hormone imbalance—and mood chemistry changes—you wouldn't wish on anyone.

We realize that addressing this important aspect of your health is an extremely personal choice, and that your primary concern may well be simply getting relief, in the easiest and fastest way possible. That's why we are happy to present information to you on both conventional and alternative approaches to PMDD: both have important roles to play, and both can help you get back to feeling like yourself. Of course, we prefer the natural approach. But whatever path you choose, we want to help you be as informed and educated as possible, so that you can make an empowered choice for yourself.

PMDD Medications

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Common Antidepressant Medications: