![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by DaBoss on April 19, 2010, at 17:25:00
I recently went off Lexepro and am still on Wellbutrin. Since going off Lexepro I have noticed that my depression 10 days prior to menses has increased. Might anyone know of/have experience with medications that can be used for part of the month? I know of Sarafem which I understand is Prozac but does anyone have any other recommendations/insights? Thank you in advance!
Posted by evenintherain on April 19, 2010, at 18:24:13
In reply to Alternatives to SSRI for PMDD, posted by DaBoss on April 19, 2010, at 17:25:00
I have heard of Zoloft being affective for PMDD, but that is an SSRI too. You never know though, it could help?
Posted by DaBoss on April 19, 2010, at 18:37:25
In reply to Re: Alternatives to SSRI for PMDD, posted by evenintherain on April 19, 2010, at 18:24:13
Thanks evenintherain. I guess I should add that I would like to stay away from SSRIs due to sexual dysfx side effects. Looking for alternatives....
Posted by janejane on April 19, 2010, at 18:53:45
In reply to Alternatives to SSRI for PMDD, posted by DaBoss on April 19, 2010, at 17:25:00
Well, if you want to avoid SSRIs... Yaz (birth control pill) is approved for PMDD, though some women say it makes their depression worse. My (uneducated) guess that though it sometimes works, it might not have the correct balance of estrogen and progesterone for everybody. (There is one school of thought that suggests that anxiety type premenstrual symptoms are due to low progesterone while depression type symptoms are due to low estrogen. That would make it hard to have a one-size-fits-all solution.)
It's no secret that hormones affect mood. (Just ask all the perimenopausal women whose mood plummets with their hormone levels.) So, since your symptoms are linked to your cycle, you might want to get your hormones tested and try to correct any imbalances found. For example, if your progesterone is low, your doc might write you an Rx for Prometrium, which is micronized progesterone. Would it help your PMDD? Maybe. Progesterone inhibits COMT which in turns affects some neurotransmitters important in depression. Estrogen too affects mood, I believe through its affect on MAO (among other things, I'm sure). In younger women, estrogen dominance is supposedly a more common problem than deficiency, and causes symptoms of progesterone deficiency due to the imbalance. (Honestly, this chemistry stuff really confuses me, but I want you to know there's a scientific basis for this.)
There are progesterone creams you can buy over the counter but I probably wouldn't try them without getting your hormones tested first because if your problem turns out to be low estrogen rather than low progesterone, increasing progesterone might just exacerbate your symptoms. (They oppose one another somewhat.)
Posted by morganator on April 19, 2010, at 23:04:30
In reply to Alternatives to SSRI for PMDD, posted by DaBoss on April 19, 2010, at 17:25:00
If you did end up having to resort to an SSRI again, Zoloft may not give you the sexual side effects that Lexapro did.
Posted by Deneb on April 20, 2010, at 0:52:13
In reply to Alternatives to SSRI for PMDD, posted by DaBoss on April 19, 2010, at 17:25:00
Hello DaBoss!
Welcome to Psycho-Babble! It is tricky finding an SSRI that won't give you sexual dysfunction. I hope you find an alternative.
Deneb
Posted by desolationrower on April 23, 2010, at 17:13:41
In reply to Alternatives to SSRI for PMDD, posted by DaBoss on April 19, 2010, at 17:25:00
agree with janejane
a drug with prozac in it doesn't make sense since fluoxetine has a super long half life
there are also otehr options for reducing side effects
-d/r
Posted by bulldog2 on April 24, 2010, at 14:14:13
In reply to Alternatives to SSRI for PMDD, posted by DaBoss on April 19, 2010, at 17:25:00
> I recently went off Lexepro and am still on Wellbutrin. Since going off Lexepro I have noticed that my depression 10 days prior to menses has increased. Might anyone know of/have experience with medications that can be used for part of the month? I know of Sarafem which I understand is Prozac but does anyone have any other recommendations/insights? Thank you in advance!
maos? Parnate first
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.