UPDATES:’HAPPY’ DRUG FOR MONTHLY BLUES

Prozac the “happy drug” to ease depression could soon be called up to treat PMS sufferers as well.

Researchers from McMaster University in Hamilton, Ontario, Canada have discovered that fluoxetine (marketed as Prozac) can ease some of the symptoms of premenstrual syndrome.

They warned, though, that only doses of 20 mg a day should be prescribed. When they tested at 60 mg, a third of the women dropped out because of side effects, while the vast majority of those remaining in the trials complained of one or more side effects.

Doctors may have trouble convincing some women to take it, however. Researchers found it difficult to recruit women for the trials, because of the bad press surrounding Prozac, and its supposed ability to make people suicidal or violent. “None of the women we studied had any suicidal or homicidal tendencies during the trial,” said the researchers comfortingly.

Clearly, the drug does not come without its own set of problems. The overall drop-out rate during the trials which included those on 60 mg and 20 mg doses was a high 42 per cent. Researchers were also unclear whether a daily dose was necessary. Another study has discovered that just one dose per month was as effective as taking it daily.

One thing was clear, though: the symptoms returned the moment the woman stopped taking the drug (NEJM, June 8, 1995).

l Despite being hailed as the great new wonder drugs, the SSRIs (selective serotonin reuptake inhibitors) such as Prozac are only as effective as the tricyclics they are replacing, and tolerance of them is only 10 per cent better.

Researchers, who analyzed several studies, said the 10 per cent difference may not be significant. For every nine people who dropped out of SSRI treatment, 10 would stop the tricyclics.

Although the SSRIs are fast becoming the first line of treatment, the researchers felt that the tricyclics should assume their old status because of the negligible difference in effectiveness and tolerance, and because they are far cheaper than the SSRIs (BMJ, 1995; 310: 1433-1438).