Study: Anti-depressant helps relieve severe PMS
September 23, 1997
Web posted at: 7:44 p.m. EDT (1944 GMT)
(CNN) -- Women suffering from a severe form of premenstrual
syndrome can find relief by taking an anti-depressant similar
to the popular Prozac, a study published Tuesday suggests.
More than 60 percent of the women given the drug sertraline
hydrochloride, manufactured by Pfizer Inc. and sold under the
brand name Zoloft, showed improvement in symptoms, researchers
from the University of Texas Southwestern Medical Center at
"These women either felt totally well or nearly totally
well," said Dr. Kimberly Yonkers of the University of Texas
Women who had psychological symptoms got the most relief, she
"I can't say that medication would be as effective for women
who had predominantly physical symptoms, such as headache,
breast pain or bloating," she said. "Those symptoms did
improve with our treatment, but we found much greater
improvement for the emotional or behavioral symptoms."
Severe form of PMS can last weeks
Participants in the study suffered from premenstrual
dysphoric disorder, a severe form of PMS that causes serious
impairment in 3 percent to 5 percent of menstruating women.
Women with the disorder report spells of anger, irritability,
depression and moodiness that can last as long as two weeks,
threaten their relationships and hamper their own
By contrast, PMS lasts a day or two each month, and symptoms
range from irritability and feeling emotional to food
cravings and bloating.
"Women with PMS are still very functional in their work, in
their relationships and in all aspects of their life," said
Dr. Anita Clayton of the University of Virginia. "Whereas
when you have premenstrual dysphoric disorder, you become
dysfunctional in at least some of those areas."
'Mood swings were bad for ... everyone'
For Danielle Hepner, the disorder became so severe she could
"I couldn't come to work, couldn't function at work, cramps
were bad, the mood swings were bad for me and for everyone
else," she said.
"It would last the whole week or two weeks and there was
nothing anybody could say or do for me. ... I couldn't go
out, I couldn't exercise," Hepner said.
Hepner eventually found relief by taking an anti-anxiety drug
and said she's "dramatically" better.
"I'm a lot happier. I'm a lot easier-going person," she said.
Drug increases serotonin level in brain
Drugs like Zoloft work by enhancing the level of the
neurotransmitter serotonin in the brain. Zoloft is among a
class of drugs called serotonin reuptake inhibitors. Prozac
is the most widely used of these drugs.
In the Texas study, published in the Journal of the American
Medical Association, 200 women with premenstrual
dysphoric disorder were given either Zoloft or a placebo.
Sixty-two percent of the women given Zoloft showed "marked or
much improvement" in symptoms, while 34 percent of those
taking a placebo showed similar improvement, researchers
The study was paid for by Pfizer. But additional research
shows that other anti-depressants similar to Zoloft work just
In an editorial that appeared alongside the study in JAMA,
psychiatrist Judith Gold wrote that previous studies over the
past decade have found that anti-depressants can benefit
women with the disorder. But little or no benefit has been
found from taking progesterone, estrogen, diuretics, vitamins
or herbal or mineral preparations.
Many women suffer in silence
"There's a good body of medical evidence to suggest not
necessarily a cause and effect relationship, but a very
strong association between low levels of serotonin in the
brain and certain mood symptoms in women with PMS," said Dr.
Samuel Smith of Sinai Hospital of Baltimore.
Most women with severe PMS suffer in silence, doctors say,
because it's something society has taught them they have to
"There are a lot of women out there who are not getting help,
partly because it's misunderstood, not just by family
physicians but by people in the general community," Clayton said.
It's a poorly understood illness, but treatable if properly
Medical Correspondent Rhonda Rowland and Reuters contributed to this report.