In Practice

A Practicing Doctor's Views on Psychiatry and Contemporary Culture.

Peter D. Kramer is a psychiatrist and author. His books include Against Depression and Listening to Prozac. See full bio

July 23, 2008, Depression

Comments on "Another Quick Effect of Antidepressants"

Another Quick Effect of Antidepressants

By Peter D. Kramer on July 23, 2008 in In Practice

How fast do antidepressants act? It depends what’s being treated. Premenstrual irritability responds within hours.
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The chicken or the egg

Submitted by david Petropoulos on July 23, 2008 - 5:10am.

Another probability in my opinion, which might mean little, is these women have depression and it's intensified or manifested differently during their menstrual cycle. They may be passive depressives then become angry during their cycle,hence blame their menstrual cycle. It's a bit like treating a thyroid problem,does the depression really go away,or just the severity of symptoms.Is the body chemically altered bringing on the depression or does depression alter the body chemically. Maybe both can occur but i always side with depression considering so many people haven't a clue what to look for.For the record i know people who blame these other causes for their ''moodiness'',again in my undoctorly opinion. Sincerely-David

Misunderstanding PMS

Submitted by Allison on July 23, 2008 - 9:43am.

Given the fact that I am basically a happy person and a therapist who is trained to recognize depression I can attest to the fact that PMS is a recognizable set of symptoms that don't require an underlying depression.
The drop in my own serotonin is like clock work. So predictable that I have almost resorted leaving notes for the Mrs. Hyde who will soon emerge-something along the lines of, "Allison you really don't hate your husband, your job or your life! This will pass."
Dr. Kramer? I had a significant change in symptoms on Sarafem. Are there other drugs you have seen some success with?

Thank you

Submitted by Dawn on August 15, 2008 - 8:35am.

I wish I could find a therapist like you; someone who could really understand and discuss PMS and not just blame it on depression; Yes I have been diagnosed with depression and have had problems with PMS since I was 17 - now I am 40 and the PMS is a lot worse; yes I am on medication and have tried everything; The depression is much worse when I have PMS; I haven't found a doctor that will listen or that can help me with the right hormones yet; I tried the deproprovera shot and it was the biggest mistake ever; I was extremely ill; couldn't eat lost weight and severly depressed; I have never had much luck with hormones and I think birth control pills may have played a role in the problems with PMS and depression;

Maybe misunderstanding depression

Submitted by david Petropoulos on July 23, 2008 - 3:53pm.

Happiness is generally a poor assessment of weather one has depression or not. Low self esteem is a better marker. Nothing would please me more if you were a rare case and you prove me wrong.I still believe one falls into the range of depression even if it's a low grade,and it's simply exacerbated during a woman's cycle. sincerely David

sarafem = known

Submitted by Anonymous on July 24, 2008 - 8:29am.

some yrs ago, sarafem was marketed for pms. with that lady getting aggravated by the shopping cart. sarafem is prozac. thus, to be marketed for pms, it must have been approved by fda for that purpose, thus must have had clincal evidence for fda approval process. so, this recent study may just be more evidence on the topic.

at the time - it was abt 1999 - i commented to a lilly drug rep how it was crazy to market a drug that takes at least two weeks to reach effectiveness for a disorder that is briefer in duration than 2 weeks. the drug rep said that the effect is by serafem/prozac/fluoxetine acting on different receptors.