<p>Warning- this thread is probably only going to interest women only.
Premenstrual dysphoric disorder or Prementrual depressive disorder
Does anyone have any experience with this? Treatment options?</p>
<p>I have treated this in my practice (although not for awhile).
I had the best luck with monophasic contraceptive pills and cyclic Prozac for my patients.
Seasonale would be a good option, too, since it would be a monophasic that eliminated menses for 3 months.</p>
<p>I’ve also had women in my practice with it - very severe. Prozac worked well.</p>
<p>How would you give someone an SSRI cyclically? Wouldn’t that mean that the patient would have to endure discontinuation symptoms for part of every month?</p>
<p>Well, unlike a typical depression where a SSRI takes 6-8 weeks to start to really work, I found that taking Prozac just for the two week post-ovulation was sufficient to alleviate symptoms. And, I also had luck with patients taking weekly Prozac once a week for the two weeks before their periods. There weren’t withdrawal sx off the Prozac.</p>
<p>It would be fine to be on regular daily prozac, too. But some women didn’t want to take medicine every day. </p>
<p>There may be more recent studies that have changed tx protocols, but I had very good luck with several of my patients with this routine when I was in family practice.</p>
<p>prozac has a long half life so it probably wouldn’t be that bad to discontinue.</p>
<p>Yaz…seems to lessen symtoms.</p>
<p>What does your doctor say? There are many ob/gyns who have lots of experience with PMDD and could help you. It is always important to talk to a doctor about sx so they can assess whether there are other health issues, medications, etc that could be contributing.</p>
<p>I am glad it looks like the experiences here support what her Dr has told her.The patient is my young 20’s D. From everything we have read she seems to fit the criteria for PMDD. After one year off any meds at all she is hesitant about going on anything but her quality of life is definitely compromised. She feels she really only gets 10 good days a month. After 6 months of tracking we have realized her extreme mood swings and agitation and other symtoms are related to her menstrual cyle.
She has talked with both a psychiatrist and a ob/gyn. My D went in thinking she would try Yaz but both the psychiatrist and Gyn said they see best results with both birth control pills in combination with an SSRI.
The Gyn sent her home with a prescription for a birth control pill (name is escaping me but I know it comes in generic) and Serafem. It looks like Serafem is basically a low dose of Prozac. She has taken Prozac in the past at a higher dosage so I am not so concerned about side effects of the Prozac. The Dr is recommending she take the B/C pills for 3 months without taking the pacebos. Basically making her only have her period every 3 months. She will also take the Serafem daily. My D also has severe cramping and long periods so the period every 3 months should help.</p>