And Now: Study Suggests That Prozac Could End PMS

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Prozac could end misery of premenstrual syndrome


Millions of women could be spared the monthly misery of premenstrual syndrome by taking a small dose of the anti-depressant Prozac, a study suggests.

British researchers have discovered that the commonly prescribed pill can block the changes in the body that cause the “symptoms” of the debilitating condition, which effects three quarters of women.

And because it has already been tested, it should mean that it could be available much more quickly than new drugs that have to go through numerous safety trials.

“A lot of women have it and a lot of men are on the receiving end of it,” said Dr Thelma Lovick, who led the research at the University of Birmingham.

“Some women really suffer and their families suffer as a result. The solution could be as simple as taking a pill for a few days towards the ends of your menstrual cycle.’”

The majority of women experience some symptoms of PMS, ranging from stomach bloating and irritability, to violent mood swings so bad that they consult their doctor.

Not all women show all the symptoms, but it has been estimated that 75 per cent experience some and that, in 30-40 per cent of cases, they are sufficiently severe to impair daily activities, with knock on effects for family and friends.

In the worst cases (three to four per cent of women), a psychiatric condition called Premenstrual Dysphoric Disorder (PMDD) can develop.

Dr Lovick, who outlined her findings at the British Science Festival, came across the possible treatment as she was investigating the cause of PMS.

She found that the build up of the sex hormone progesterone before ovulation has a knock on effect on a steroid called allopregnanolone (ALLO).

This latter substance soothes the brain and has a calming effect on the emotions.

When levels of ALLO drop sharply during the late premenstrual period, this effect is reduced and symptoms of PMS, such as anxiety, irritability and aggression, emerge.

“As a consequence these brain circuits become more excitable, leaving the individual more responsive to stress, which is often manifested behaviourally as anxiety and aggressive behaviour.

Dr Lovick hypothesised that if the sharp fall in ALLO levels is the factor that triggers these brain changes, then if you could make ALLO levels decrease gradually at the end of the cycle, the symptoms of PMS should not develop

Using this premise, the Birmingham group has devised an approach termed ‘neuroactive steroid replacement treatment’, which has been shown to completely prevent the development of premenstrual symptoms in rats.

“We knew that the widely used anti-anxiety drug fluoxetine (Prozac) could raise levels of ALLO when taken for short periods,” she said.

“This effect happened quickly and occurred in response to a very low dose of fluoxetine’ says Dr Lovick.

“We thought that if dosing with fluoxetine was carefully timed to boost brain ALLO levels just when they were due to fall sharply at the end of the cycle, the normal trigger for the development of premenstrual syndrome would be absent.”

Most significantly, the dosage needed to achieve this was only about one tenth of the standard strength of the most commonly prescribed form of fluoxetine.

The team were “astonished” to find that it completely prevented signs of annxiety and increased pain and sensitivty normally found in femal rats during their version of the premenstrual period.

To our amazement it completely blocked the symptoms,” she said.

“Moreover, it completely changed the way in which the brain circuits responded to anxiety-inducing stress,” she said.

The team, which are funded by the Medical Research Council, now plan to carry out a controlled tril in women.

Professor Tim Kendall, of the Royal College of Psychiatrists, welcomed the research but warned that self-medicating with Prozac could be “disastrous”.

“Prozac is associated with a number of different side-effects. The most common is sexual dysfunction, it can lower libido and induce


“It can stop you sleeping and make you anxious and wound-up and affect appetite. And particularly in young people, under the age of 30, it can trigger suicidal thoughts and self-harm.”

“PMS makes a lot of women quite miserable and if there is something we can do for them, that would be very good.

“But it is too premature to say this is the thing.”

Prozac is sometimes prescribed by doctors for PMS but in the full dose and usually to treat depression.

By Richard Alleyne, Science Correspondent
Published: 3:38PM BST 17 Sep 2010

Source: The Telegraph

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