77 / 128
Case Studies
77 •
placebo
: An inert or
innocuous substance
used specially in con-
trolled experiments
testing the efficacy of
another substance as a
drug.
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
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,