Looks at medicine sometimes used to treat PMS and PMDD symptoms like depression, anxiety, hot flashes, and chronic pain. Lists generic and brand name antidepressants like fluoxetine (Prozac) and paroxetine (Paxil). Covers how they work and side effects.
Selective Serotonin Reuptake Inhibitors (SSRIs) for PMS and PMDD
many women, SSRI medicine need only be taken during the premenstrual phase,
generally 2 weeks before the start of menstrual bleeding.
How Well It Works
SSRIs may help relieve the emotional and physical PMS and PMDD symptoms.1 SSRI therapy can bring relief within a few days of starting
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Usually the benefits of the medicine are more important than any minor side effects.
Side effects may go away after you take the medicine for a while.
If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
Swelling of your face, lips, tongue, or throat.
Call your doctor if you have:
Thoughts of suicide.
Agitation and restlessness.
Nausea and vomiting.
Common side effects of this medicine include:
Loss of sexual desire or ability.
Trouble sleeping or drowsiness.
Changes in appetite.
FDA advisories. The U.S. Food and
Drug Administration (FDA) has issued:
A warning about taking triptans, used for headaches, with SSRIs
(selective serotonin reuptake inhibitors) or SNRIs (selective
serotonin/norepinephrine reuptake inhibitors). Taking these medicines together
can cause a very rare but serious condition called serotonin syndrome.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
You can take a selective serotonin reuptake inhibitor
(SSRI) by mouth every day of the month. Or you can take an SSRI daily between
the day you ovulate and the start of your period (usually about 2
SSRI treatment is not recommended if you have a seizure disorder or a
bipolar disorder). These conditions can be made worse
by an SSRI.
bleeding more likely in the upper gastrointestinal tract (stomach and
esophagus). Taking SSRIs with NSAIDs (such as Advil or Aleve) makes bleeding
even more likely. Taking medicines that control acid in the stomach may
As with any medicine,
some medicines can adversely interact with an SSRI. Before you try an
SSRI, discuss your medicine and
dietary supplement use with your doctor.
When you are taking an SSRI continuously, never stop taking it abruptly. The long-term use of an SSRI should be tapered off
slowly and only under the supervision of a doctor. Abruptly
stopping SSRI medicines can cause flu-like symptoms, headaches, nervousness,
anxiety, or insomnia.
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
Advice for women
Women who use this medicine during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Kwan I, Onwude JL (2009). Premenstrual syndrome, search date July 2009. Online version of BMJ Clinical Evidence:
How this information was developed to help you make better health decisions.