Women: Effexor and PMS?


Question:
I've been on Effexor for three months; while it's been brilliant at reducing depression, I'm still experiencing terrible PMS.

Prior to Effexor, I'd tried two other medications, Prozac and Citalopram - neither helped the depression at all, but both reduced the PMS!

Just wondered if any other women out there have found that Effexor doesn't tackle PMS too well?

Thanks for your time.

Answers:
Neither Prozac, nor Citalopram are currently licenced for PMS, neither is Effexor, so none of these drugs should at present be used with this sole aim in mind. Prozac did have such a licence, but it was voluntarily withdrawn by the company. This was as much due to media pressure, suggesting its general over use, as any other reason.

PMS is perhaps best treated with an initial trial of Vitamin B6 at a dose of perhaps 50mgs/ day. ( this is a prescription only dose) The next most useful approach is to use hormones, either the pill or norithisterone.
Are you taking birth control? Sometimes the pill helps with PMS as well as cramping and bloating and all that.
Effexor works on both the seretonin and noradrenaline pathways in the brain leading to a build up of both and consequently help to alleviate depression
Citalopram and prozac are SSRI's which work only on the serotonin pathways. there is no build up of noradrenaline other than that already circulating. Effexor would generally be used in cases not responding to the other two.
I am not clear why effexor has not helped your PMS but ths may be due to the antagonistic effects of noradrenaline, a similar chemical to adrenaline on your hormone levels. B6 vitamins, although popular, have not been shown in reputable studies to be effective. Neither has evening primrose oil, more likely to be placebo effect although the combined oral contraceptive has been shown to be helpful in some cases. The fact that you have depression (which is thought to be due to chemical imbalance in the neural pathways in the brain) may also be a reason for worsening of you pms.
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