PROZAC AND PREMENSTRUAL DYSPHORIC DISORDER: An old remedy for a new diagnosis

Presents information on premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome in the U.S. Percentage of menstruating women afflicted by PMDD; Prescription of Eli Lilly's Prozac and Serafem selective serotonin reuptake inhibitors (SSRI) for women; Effectiveness of SSRI for women suffering from PMDD.

By Katy McLaughlin, published on March 01, 2002

FEMALE TROUBLE

PROZAC AND PREMENSTRUAL DYSPHORIC DISORDER: AN OLD REMEDY FOR A NEW DIAGNOSIS

PMS, THAT PERENNIAL IN-JOKE AMONG women, has a decidedly serious cousin: Premenstrual dysphoric disorder (PMDD), a severe form of PMS that afflicts some 5 percent of menstruating women. PMDD has been inching toward full recognition as a psychiatric disorder since 1994, but women and doctors alike remain largely ignorant of the condition.

"My PMDD almost led to divorce and suicide," says 31-year-old Anthea Williams, who two years ago began experiencing extreme mood swings, intense anger and severe depression the week prior to her period. When her primary care physician threw up his hands, Williams' Internet research led her to conclude that she had PMDD. Her physician concurred and prescribed Prozac. Williams calls the selective serotonin reuptake inhibitor (SSRI) a "lifesaver."

Eli Lilly, the maker of Prozac, was the first company to receive FDA approval to indicate an SSRI--Serafem--for the treatment of PMDD. But Prozac and Serafem are, in fact, the exact same drug. Critics contend that the new name is a ploy for profitability, as the patent on Prozac expired last August, while Serafem remains protected until 2007. Eli Lilly argues that a distinct identity is appropriate, as it distinguishes PMDD from depression, with which Prozac is most widely associated.

PMDD is included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a disorder that is still under evaluation. Jean Endicott, Ph.D., director of the premenstrual evaluation unit at Columbia Presbyterian Medical Center in New York City, testified before the FDA supporting recognition of PMDD as a distinct clinical entity. Endicott also conducted PMDD studies with Zoloft, which she says is likely to receive FDA approval for a PMDD indication in the near future.

"SSRIs are effective for about 65 percent of women [suffering from PMDD]," says Endicott, who notes that physicians as ancient as Hypocrites recognized the suffering caused by premenstrual symptoms. "Fortunately, women are no longer told nothing can be done."

PHOTO (COLOR): MY PMDD ALMOST LED TO DIVORCE AND SUICIDE