View Full Version : SSRI cycles for PMDD


kristin.m
04-13-07, 10:56 AM
I recently started taking a small dose of a SSRI to treat PMDD symptoms that occur ONLY when I am taking strattera. I take it in two-week cycles -- 10mg of lexapro plus 60mg strattera during the "bad" two weeks and nothing but my strattera during the "good" two weeks.

I wondered if anybody else has done this, because I have questions my pdoc hasn't been able to answer satisfactorily.

Do the side effects of starting a SSRI occur for each cycle?

Have you experienced SSRI "withdrawal" symptoms during the two weeks off? (I know that "withdrawal" isn't the correct term... I just couldn't think of it at the moment!)

Do the "withdrawal" symptoms go away after additional cycles?

My pdoc said I shouldn't have any "withdrawal" symptoms but I have had some low grade ones (e.g., mild headache, nausea). If starting and stopping side effects are going to happen every month, I think I'd just rather take lexapro all the time and avoid the extra headaches!

Thanks!

justhope
04-13-07, 11:28 AM
I had bad luck wiht SSRI"s but then again, I am BPD.....I , however , have PMDD, and I actually take .05 t0 1mg of Risperdal for mine? Only the 3-5 days precedeing the "monster"...

My understanding is SSRI's are a blood level med? Meaning you need to take them for at least 4-6 weeks to have a level beneficial enough to feel the "relief"?
So if you are only taking it 2 weeks out of the month, my question would be, how is it working at all?

I also don't anything about Strattera, I am on standard stimulants, and always have been. My "cycles" were never effected. I know my sister had to be prescribed Lasix during that time ,because the "severe" bloating, actually caused enough fluid on her brain to resembler psychosis....She doesn't need Risperdal? It works for me just fine.....


If you aren't getting satifactory answers, perhaps you might consider getting a second opinion on the whole PMDD , meds etc.

kristin.m
04-13-07, 11:50 AM
Thanks for your reply.

The only unanswered question was the one you identified: why do SSRIs work in such a short period of time for PMDD, when it can take weeks for them to work for regular depression? I can attest that they do work for PMDD. I went from laying on the couch wishing to die in my sleep so I'd stop feeling so incredibly awful to feeling pretty much like my normal self within 72 hours. To my knowledge, this is unheard of for regular depression. Plus, all the non-depressionlike PMS symptoms were eliminated or completely reduced.

The doc currently managing my meds doesn't know why they work for PMDD... she just knows that they do. She's a resident, and her supervisor keeps mentioning the "serotinergic effect" but the supervisor never elaborates! Perhaps my regular pdoc will be better able to explain it when I see her in another couple weeks. I'm not too hopeful, because she's also a resident, and has the same supervisor as my stand-in doc.

QueensU_girl
04-13-07, 01:31 PM
Prozac can be taken in one dose.

Prozac has a kazillion hour half life and stays on the system for one week. There is a Pill that Eli Lilly put out called "Prozac Weekly". It is just 80 mg of Prozac (4 doses) in ONE pill.


------------

Good and Bad of long 1/2 Life:

(Docs don't like to Rx Prozac as much any more due to it's long 1/2 life. Takes a while to get out of the system if someone has a side effect.)

I have never heard of Prozac causing withdrawal when stopped suddenly, y'know? (And i spend many years talking to people on Alt.Support Depression, etc.)

It can, in fact, but used to ease the withdrawal of stopping the OTHER short-acting SSRIs and SNRIs (eg Paxil, Effexor)

Eli Lilly markets Prozac under the name Sarafem for PMS/PMDD. Same thing as Prozac.

Mostly I just look after my own PM yucky feelings by getting some hard exercise (v. fast walking) for 30 min 2x/day the week b4 my period.

kristin.m
04-13-07, 02:27 PM
My pdoc said that strattera can interact with prozac. It doesn't for everyone, but she's hesitant to prescribe the two simultaneously now that she's had two problem cases in the recent past.

I wish this balancing were easier... or that I could make myself exercise hard to help balance everything out during the bad weeks.

justhope
04-14-07, 02:22 PM
Thanks for your reply.

The only unanswered question was the one you identified: why do SSRIs work in such a short period of time for PMDD, when it can take weeks for them to work for regular depression? I can attest that they do work for PMDD. I went from laying on the couch wishing to die in my sleep so I'd stop feeling so incredibly awful to feeling pretty much like my normal self within 72 hours. To my knowledge, this is unheard of for regular depression. Plus, all the non-depressionlike PMS symptoms were eliminated or completely reduced.

The doc currently managing my meds doesn't know why they work for PMDD... she just knows that they do. She's a resident, and her supervisor keeps mentioning the "serotinergic effect" but the supervisor never elaborates! Perhaps my regular pdoc will be better able to explain it when I see her in another couple weeks. I'm not too hopeful, because she's also a resident, and has the same supervisor as my stand-in doc.
Interesting, I didn't mean for you to have to answer me..LOL...it was a random thought.in writing...
I will have to read up on it more, I like to research new stuff, just to add more junk in my already overfilled brain!

I"m just curious, because I know a friend of mines wife was taking Zoloft for hers. It's just hard to me to grasp....just cause it's a blool level med normally....but then again, I am on an anti-convulsive for BPD.., so hey I suppose that is why doctor's know what meds work and what don't right, and of course it doesn't apply to me cause I can't be in any anti-depressants/ SSRI's or otherwise, because of my own condition. Doesn't mean other's can't great thing if it works!

I hope it all works out for you, I know my family was happy when I found something that worked for me, so they don't have to get a hotel for the week! :eek:

HighFunctioning
04-15-07, 09:52 PM
Anti-depressants have an effect on serotonin immediately. There are several hypotheses as to why it takes several weeks for anti-depressants to treat depression, but that doesn't mean the medication doesn't have an effect, and it's probably not related to blood-level either. They do accumulate, but only to a point. Prozac probably does it the best, but most anti-depressants have a half-life that's less than a day, so most likely, you'll be at peak levels in less than 7 days.

Who knows... PMDD might be a purely serotonogenic problem (after all, I would think PMDD has a quick onset, whereas depression may develop over a long time... and often the time to treat is a reflection of development time).

kristin.m
04-17-07, 09:40 AM
Interesting explanation! Thanks for the contribution, HighFunctioning...