Premenstrual Disorders

symptoms in their thirties and forties, when they begin having chil- dren and experiencing stress on a more consistent level. For them the changes sometimes creep up and get out of control before they think to get some help. Ellen Freeman, research professor in the departments of psy- chiatry, obstetrics, and gynecology at the University of Pennsylva- nia Medical School, served as a consultant to the DSM-IV PMDD Work Group. She and her colleagues performed a controlled trial monitoring the benefits of SSRIs, specifically Sarafem (Prozac), on the psychological and physical symptoms of women suffering with

PMDD. Using the Penn Daily Symp- tom Report, those who took the an- tidepressant scored 50 to 65 percent fewer symptoms than they did when they were not taking the drug; there was only a 29 percent decrease in the placebo group. Freeman also found that those on the tricyclic antidepressant desipramine scored no better than the placebo. Since an antidepressant that does not work to change serotonin lev- els made no difference for women suf- fering from PMDD symptoms, it adds to

placebo : An inert or innocuous substance used specially in con- trolled experiments testing the efficacy of another substance as a drug.

the proof that serotonin plays an important role in PMDD and PMS. Another test, reported by the pharmaceutical company Pfizer, studied Zoloft’s effectiveness for treating PMDD. One group used the drug on a daily routine, while the other only used it during the luteal phase the two weeks before the onset of menses. The women studied were given from 50 to 150 milligrams a day, according to their response to the drug and their individual tolerance. Daily use of the drug raised the score of the tests significantly more than those of the women on the placebo. The scores of the women who took Zoloft only during the luteal phase also reflected a positive change. Maryann is an example of a woman who needed help from SSRIs. She worked for a printing company in an average-size town,

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Case Studies