Fluoxetine (Prozac) has become the first prescription medicine to be licensed for treatment of pre-menstrual dysphoric disorder (PMDD, a severe form of premenstrual syndrome).
Professor Shaughn O'Brien (department of obstetrics and gynaecology, Keele university) said in a press release issued by Lilly, the UK manufacturer: "The most common and distressing emotional symptom for women suffering from PMDD is irritability, with breast tenderness and bloating among the most common physical symptoms. Combined with features of depression and anxiety, these symptoms are not only distressing but may also seriously interfere with work, social activities and relationships."
Professor James Drife (department of obstetrics and gynaecology, Leeds General infirmary) told The Journal on September 22 that some women might wish to use a less emotive treatment than Prozac, while others might welcome it. He added: "GPs are likely to feel the same, depending on their previous experience with the drug. The GP is likely to be the first port of call for women and, if referral is necessary, the GP will use a gynaecologist who specialises in menstrual disorders. Most gynaecologists will have had no experience of prescribing fluoxetine to date".
The exact cause of PMDD is not known but, according to the Prozac summary of product characteristics, the effect on symptoms is usually rapid, with improvement generally occurring during the first cycle of treatment. According to the product prescribing information, clinical trial results and observations suggest that, following the cessation of treatment, PMDD symptoms tend to return within one or two cycles.