Alarm over rising number of women being prescribed Prozac for PMS 'inappropriately'
By Jenny Hope
Last updated at 11:00 PM on 07th August 2008
Rising numbers of women with premenstrual syndrome are being treated with antidepressants, a leading charity claimed yesterday.
But many find that the pills do not work - and the side effects can be worse than period pain, according to the National Association for Premenstrual Syndrome, or NAPS.
The majority of women experience some symptoms of PMS, such as stomach bloating and irritability, and two in five suffer from problems such as violent mood swings, which are so bad that they consult their GP.
Growing trend: Rising numbers of women with PMS are being treated with Prozac and similar antidepressants
Thousands are prescribed progesterone, the pure form of a natural hormone linked to PMS, or the synthetic version called progestogen.
But there is a growing trend for doctors to use drugs such as Prozac before they have investigated the problem or tried less radical treatments.
Antidepressant side effects include dry mouth, weight gain and loss of libido.
Claudine Domoney, a consultant gynaecologist at Chelsea and Westminster Hospital in London, who advises NAPS, said: 'Before dishing out such strong pills, doctors should encourage women to make simple lifestyle changes.
'A low-sugar, wholegrain diet and regular exercise regime can help ease PMS symptoms and some women find supplements such as evening primrose oil and agnus castus effective.
'Doctors should always explore other avenues before handing out antidepressants for PMS - it shouldn't be first-line treatment.Why give a young woman a drug with potentially serious side effects when it might not be necessary?'
A recent study by NAPS of calls to its hotline found a 'surprisingly high' proportion of PMS sufferers are being prescribed antidepressants. A spokesman said it might explain the significant growth in the prescribing of Prozac and similar drugs to women.
But too little effort was being made to explore the relationship between depressive episodes and PMS, with many women 'too readily categorised as mentally ill'.
This can lead to profound problems for some women, the charity said.
The patient's medical notes wrongly label her as mentally ill, which might affect her prospects of getting employment and insurance cover.
The spokesman added: 'GPs must differentiate between mental health symptoms and those arising from the reproductive cycle.
'It is important to understand particular hormonal patterns for women of reproductive age before burdening them with medication which does not address the cause of their particular symptoms.
'All women patients of reproductive age with psychological symptoms should plot their symptoms against their menstrual cycle.
This will significantly improve the accuracy of diagnosis and reduce the misprescribing of antidepressants.'
Dr Domoney agreed, saying: 'If your GP wants to put you on antidepressants for what you believe is PMS, press them for a diagnosis and ask exactly what they're treating you for.'
Liz Holworth, 29, a software engineer from London with severe PMS, said it took her a long time to get the right help.
She said: 'I felt like a hypochondriac and, because GPs seemed so unsympathetic, I started to feel it was all in my head.
'I'm not on antidepressants now and I wouldn't want to take them again.
'The drugs made me feel dopey in the day and stopped me sleeping at night.
'I'm now on hormone treatment. My PMS didn't completely disappear but it reduced to a few days a month.'