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Study: Anti-depressant helps relieve severe PMS

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 Dallas found.

vxtreme Study: Anti-depressant helps relieve severe PMS

"These women either felt totally well or nearly totally well," said Dr. Kimberly Yonkers of the University of Texas Southwestern.

Women who had psychological symptoms got the most relief, she said.

"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 productivity.

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 barely function.

"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.

Danielle Hepner

"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 found.

The study was paid for by Pfizer. But additional research shows that other anti-depressants similar to Zoloft work just as well.

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 live with.

"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 diagnosed.

Medical Correspondent Rhonda Rowland and Reuters contributed to this report.

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