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Prozac for PMS (PMDD)?
by Dr. Joseph Mercola

Pharmaceutical giant Eli Lilly is promoting Sarafem as a miracle pill for women suffering from PMDD, a 'mental disorder' not yet proved to exist. What's more, Eli Lilly admits that Sarafem has the same active ingredient as Prozac, complete with the same dangerous side effects.

This "mental disorder" - which the American Psychiatric Association (APA) has not yet accepted, but which is listed in the appendix of the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) - is called premenstrual dysphoric disorder, or PMDD.

It's a new-and-improved version of premenstrual syndrome (PMS), which also has not made it to the hit parade of the official APA list of mental illnesses. The fact that PMDD is listed only in the diagnostic manual's appendix reflects the APA's desire for further research before accepting it as a full-fledged mental disorder.

According to the DSM-IV and the FDA, a woman must experience five or more symptoms before the diagnosis can be made.

The unofficial mental disorder is said to be characterized by the following symptoms:

Markedly depressed mood

Marked anxiety

Marked affectivity

Decreased interest in activities

Feeling sad, hopeless or self-deprecating

Feeling tense, anxious or "on edge"

Persistent irritability, anger and increased interpersonal conflicts

Feeling fatigued, lethargic or lacking in energy

Marked changes in appetite

A subjective feeling of being overwhelmed or out of control

Physical symptoms such as breast tenderness, swelling or bloating.

Eli Lilly and Co., the Indianapolis-based pharmaceutical company that makes Sarafem, has been marketing the "new" treatment with such gusto that there are jokes about the company exhibiting obsessive-compulsive disorder. It seems there isn't a magazine to be picked up or a channel to be surfed that isn't running a Sarafem advertisement.

These ads show women expressing many things. One TV spot depicts a woman trying to button her slacks and looking angry and agitated. Another scene shows a woman snapping at her husband, "Just leave me alone," while still another involves a woman slumped on the couch sobbing. Then there is the slogan: "Sarafem - More like the woman you are."

Lilly reports in its ads that now, "Doctors can treat PMDD with Sarafem - the first and only prescription medication for PMDD." The ad further states that, "Sarafem contains fluoxetine hydrochloride, the same active ingredient found in Prozac."

Dr. Mercola's Comment:

Folks, believe it or not I was a drug doctor in my early medical career.

I was probably one of the first doctors in the country to use Prozac for PMDD (the new term for PMS). in the late 80s. I actually reported its use to Eli Lilly back then, as it seemed to work so well. It is amazing to see them actually market it for that purpose a dozen years later.

I was actively involved in diagnosing and treating depression, and because emotional wounding is one of the most common causes of illness, there was plenty of it around.

I got quite good at prescribing and managing the drug side effects. In the mid 80s when I was prescribing them, only the first generation antidepressants were available and they had (and still have) plenty of side effects.

Prozac was the first of the second generation antidepressants known as selective serotonin reuptake inhibitors (SSRIs). They were absolutely incredible, as they frequently worked and they had so many less side effects.

When they worked I would look like a superstar, as if I had "cured" the depression.

Well nothing could be further from the truth. The real solution to improving depression is cleaning up the diet, exercising and addressing the emotional wounding that occurs that precipitated the cause.

While, I still recommend using these types of drugs as a temporary measure in selected cases, I hardly ever prescribe them anymore, especially for PMS.

Additionally, Sarafem and Prozac (fluoxetine hydrochloride) both are a fluorine-containing drug, which would thus further elevate fluorine exposure from sources like drinking water, toothpaste, etc.

Sometimes, women experience what they assume is PMS. However, occasionally it soon turns out that they are actually pregnant and so their period never comes. By recommending widespread use for PMS, there will undoubtedly be a small percentage of women who are unknowingly exposing their very young unborn babies to these drugs, during a period where growth and development is going on at an enormous rate.

The management of PMS certainly includes diet and exercise, it also involves optimizing the female hormones. This is done by balancing the adrenal hormones. I usually use salivary hormone testing to guide my treatment, but most of the work ultimately involves using our therapists to address the emotional wounding that usually precipitated the adrenal's impairment.

©Copyright 2004 Dr. Joseph Mercola. All Rights Reserved.

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