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Friday, 29 September, 2000, 02:34 GMT 03:34 UK
GPs seize on Prozac to treat PMS
prozac
Doctors may be too keen to prescribe Prozac for PMS
GPs may be too quick to hand a woman a prescription for Prozac when she presents with premenstrual syndrome symptoms.

One year on from Prozac gaining a UK license for use in treating severe PMS, a research review has confirmed its benefits in treating both psychological and physical symptoms.

But anecdotal information from the National Association for Premenstrual Syndrome suggests some doctors may be too keen to reach for the prescription pad rather than taking a gentler approach.

NAPS network development officer, Christine Baker said: " It seems some GPs are fairly naive and are taking a 'more rather than less' approach. We would usually urge a more gentle first line intervention, offering advice on diet and exercise things like that."

She stressed that, for many women with severe PMS, Prozac has been immensely successful, but suggested that women may also not be given enough information when prescribed it.

Two schools of thought

"There seem to be two clear schools of thought. There are those women who are tired and desperate and for whom Prozac is, by and large successful. Then there are those who think 'Why am I being put on this - I'm not depressed' because it hasn't been explained to them how it works," said Ms Baker.

Calls logged to the NAPS helpline during the month of June suggested around 10% of callers were being prescribed anti-depressants for their PMS - though research indicates only 5% of women have symptoms severe enough to need them.

salad bowl
Healthy eating benefits symptoms
The research review, covering 15 major studies into the use of serotonin-reuptake inhibitors such as Prozac for PMS, concluded that the drugs can lead to a significant improvement in symptoms for women whose "lives are completely disrupted during the second half of their cycle".

These women appear to have extreme sensitivity to circulating hormones and SSRIs can alleviate symptoms such as irritability.

The report, published in the Lancet, also suggests that the drugs can have sufficient efficacy when taken intermittently rather than constantly, when used to treat PMS.

It concludes that if women take tablets for part of their cycle only - the luteal phase - the pharmacological effect is as good as if they were taken daily, and side effects are reduced.

In PMS, Prozac and similar drugs in its class appear to become effective within a few days rather than the few weeks needed when used to treat depression.

Ms Baker welcomed the possibility that SSRIs could be used intermittently which, she said, could help those women who felt there was a stigma associated with taking an anti-depressant for their PMS.

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See also:

23 Sep 99 | Health
Prozac 'cure' for PMT
21 May 99 | Medical notes
Pre-Menstrual Syndrome
21 Jan 99 | Medical notes
Prozac
22 May 00 | Health
Prozac 'may encourage suicide'
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