Women who suffer from the most severe form of pre-menstrual tension (PMT) could benefit from taking Prozac, say researchers.
From this week, the popular and controversial anti-depressant can be used to treat premenstrual dysphoric disorder (PMDD) which is estimated to affect 1.5 million women in the UK.
The disorder stops them from functioning normally, can cause family and work problems and may be so severe that it pushes women to commit violence against others.
The causes of PMT are unknown, but may be linked to imbalances in levels of serotonin, a chemical messenger in the brain.
Women who are most at risk are thought to have a family history of PMT, a history of post-natal depression or clinical depression and are likely to suffer mood swings as a result of taking oral contraceptives.
Symptoms There are about 150 symptoms asociated with the condition.
A recent survey shows nearly 70% of women associate PMT with mood swings, depression and irritability.
Forty per cent try to ignore the symptoms and the one in five who do try to tackle the problem say they get little relief from the treatment they receive.
It is hoped that Prozac, which is said to restore serotonin levels, will reduce some of the symptoms of PMDD, although opponents say it does not address what causes the disorder.
And some are worried about the drug's side effects, which include a reduction in sex drive.
A minority of women who take it also report breast pain, early menopause or excess bleeding during periods.
Stephanie Allen, executive officer of the National Association for Premenstrual Syndrome, said PMT was often not treated seriously.
"I know many women who have lost their partners and careers as a result of suffering from premenstrual symptoms.
"I have sat and listened to numerous women describe their 'uncontrollable violence towards their partner' and 'feelings of isolation'," she said.
Professor Shaughn O'Brien from North Staffordshire Hospital in Stoke-on-Trent added: "A woman menstruates every month for more than 30 years.
"This means that she could experience premenstrual symptoms for up to 5,000 days in her lifetime, possibly without any help or advice on how to alleviate these symptoms.
It's official: A small dose of Prozac can help beat PMS
Treatment could be universally available within two years
By Steve Conno
Tests suggest that low doses of Prozac can eliminate the symptoms of PMT (Alamy)
The scourge of premenstrual tension, which affects more than half of women and causes physical as well as emotional trauma, could soon be eradicated by a safe, low-dose pill, scientists said yesterday.
A laboratory-based study has found that very low doses of the anti-depression drug Prozac can eliminate the symptoms of premenstrual syndrome, which include mood swings, tiredness, irritability, headaches and joint pains.
The scientist leading the research said the findings, which have so far been observed in laboratory rats, are strong enough to warrant a full-scale clinical trial with Prozac given that the drug has already undergone the necessary safety tests at the higher doses needed to treat depression. A clinical trial could begin within six months, and if the results are favourable, women could be taking the drug to treat premenstrual syndrome within two years, said Thelma Lovick, a neuroscientist at the University of Birmingham, who led the study.
Not all women have the monthly symptoms associated with their menstrual cycle, but it is estimated that 75 per cent have experienced them at some time and that between 30 and 40 per cent have more severe symptoms that badly affect their work and family lives.
The three-year study, funded by the Medical Research Council, has shown that Prozac taken in doses of about a tenth of that needed to treat depression can stop premenstrual symptoms in rats, animals which show physical and emotional changes, such as increased anxiety and sensitivity to pain, similar to those seen in women. Higher doses of Prozac have been prescribed to women suffering from premenstrual syndrome in the past, especially by doctors in the US, but usually for the treatment of more severe symptoms such as depression.
Dr Lovick told the British Science Festival in Birmingham that Prozac in low doses can affect levels of natural chemicals in the brain that are associated with changes in the female hormone progesterone, which rises and falls during each menstrual cycle.
Although rats have an oestrus cycle rather than a menstrual cycle, they are considered to be a useful model of what happens in humans, Dr Lovick said. "The tests we've used on rats, to our amazement, completely eliminated the symptoms. It was quite dramatic, it was not a one-off, we can repeat it," she said.
"We don't expect to see this in women. I wouldn't say it's going to cure everyone, but taken with other things, such as lifestyle changes, we may be getting there," she added.
Dr Lovick said that Prozac, also known as fluoxetine, probably reduces the premenstrual symptoms by stopping the sudden decline of a steroid substance in the brain called allopregnanolone, or "allo" for short.
"Allo can alter the activity of nerve cells, so it is described as a neuroactive steroid. It enhances the activity of GABA, one of the brain's inhibitory neurotransmitter chemicals, and in those parts of the brain that process emotional responses, allo normally produces calming effects," she said.
"However, when brain levels of progesterone, and hence allo, fall sharply during the late premenstrual period, the natural inhibition is effectively turned off," she said.
"As a consequence, these brain circuits become more excitable, leaving the individual more responsive to stress, which is often manifested behaviourally as anxiety and aggressive behaviour," she added.
The full study will be submitted to a scientific journal for peer review, Dr Lovick said.
Treating a 'severe' condition
Prozac does not have a pharmaceutical licence for treating PMS in Britain, but some doctors are already prescribing the drug.
"I've used it on patients for about 15 years," says Shaughn O'Brien, a professor of obstetrics and gynaecology at Keele University and North Staffordshire Hospital.
"It doesn't have a licence, not because it isn't effective but because for too long PMS hasn't been considered to be significant enough. But it can be severe, causing some women to suffer pain or become physically violent towards relatives.
"I prescribe doses of 20mg or occasionally 40mg, and would like to see the rationale for giving much lower doses. It is an effective treatment for a condition that deserves much more attention."
Prozac offers hope to millions suffering pre-menstrual misery
By John von Radowitz in London
A low daily dose of Prozac could end pre-menstrual misery for millions of women and their families, research suggests.
Tests on rats have shown that the antidepressant drug acts on the brain to block symptoms of pre-menstrual syndrome (PMS).
Scientists believe it could make a big difference to the 50pc of women tormented by PMS each month, a week or so before the start of their period.
Symptoms include anxiety, mood swings, tiredness, irritability, depression and loss of confidence. There may also be physical effects such as headaches, feeling bloated and breast tenderness.
The new study shows that Prozac -- the drug fluoxetine -- interferes with the way falling levels of the sex hormone progesterone affect emotion circuits in the brain.
Since the drug is already tested and commonly prescribed, it could be made widely available as a PMS treatment in as little as two years, say researchers.
Scientist Dr Thelma Lovick, from the University of Birmingham, who led the research, said: "Pre-menstrual syndrome doesn't need any introduction. Everyone's heard of it, and about 50pc of women experience it, and a lot of men are at the receiving end of it. Yet we still haven't sorted it out. Hormones "Part of the reason is we really don't quite know what causes it, but one thing we do know about pre-menstrual syndrome is that it corresponds to a change in production of one of the sex hormones, progesterone.
"We've given low doses of fluoxetine to our rats one day before they go into their pre-menstrual phase and completely blocked the development of pre-menstrual symptoms. The implications are quite wide reaching," she added.
Each month towards the end of her menstrual cycle, a woman's production levels of progesterone rapidly fall. The research showed how this could affect brain circuits involved in controlling emotions.
A progesterone breakdown chemical called allopregnanolone (Allo) normally dampens down these circuits. As progesterone levels drop, so do levels of Allo, giving rise to the classic symptoms of anxiety, moodiness and irritability.
The rat experiments show that Prozac helps to maintain Allo levels in the brain, causing them to decline more slowly.
Dr Lovick said the scientists were "amazed" to find Prozac completely erased PMS symptoms in rats.
Whereas 10 or 20 milligrams of Prozac is prescribed for depression, it is believed a daily dose of two milligrams could be enough to control PMS. And at such low doses, the drug would not have the side effects experienced by depressed patients.
RESEARCHERS AT the University of Birmingham believe they have found the cause of premenstrual syndrome (PMS). They have also tested a treatment based on the antidepressant drug Prozac, which cleared PMS symptoms in laboratory rats.
“We are beginning to understand the mechanism that underlies the development of premenstrual syndrome,” said neuroscience researcher Dr Thelma Lovick, who believes symptoms could be reduced or even eliminated.
One of the hormones that naturally fluctuates throughout the menstrual cycle also regulates emotions such as anxiety, irritability and aggression, Dr Lovick explained. This hormone drops suddenly in the week before the period, coinciding with many PMS symptoms.
The specific substance is called allopregnanolone (Allo) and usually inhibits activity in brain circuits involved in controlling emotions. “To put it simply . . . Allo calms your brain,” said Dr Lovick. There is “a sharp fall in brain Allo that I think triggers PMS symptoms”.
To test this theory, the group performed a study using lab rats. It was possible to experiment on rats because they have cycles not unlike those of humans, she explained.
Low doses of Prozac (fluoxetine) were given to rats to stimulate Allo production. These “completely blocked development of their PMS symptoms”, explained Dr Lovick.
The laboratory tests looked at anxiety levels in the rats during their equivalent to the premenstrual period.
At the British Science Festival in Birmingham this week Dr Lovick proposed a treatment regime for PMS using fluoxetine.
The drug would be taken at 10 per cent of the current standard dose for the week before the period, a dose so low that it would not retain any antidepressant effects.
Alison Jones is a British Science Association media fellow on placement with The Irish Times. ~~~~~~~~~~~~~~~~~~ UK ~ 18 September 2010
Prozac Zaps PMT
By EMMA MORTON, Health Editor Success ... Prozac pills
THE misery of PMT could be ended by a small dose of anti-depression drug Prozac, scientists believe.
The discovery is a huge boost for millions of women - AND their partners.
British experts found that just one TENTH of a normal Prozac dose banished the mood-swings, bloating and pain that blight the lives of three-quarters of women in the run-up to their periods.
Premenstrual Tension - also known as Premenstrual Syndrome - is thought to be triggered by hormonal changes around one week before menstruation begins.
In the new study by scientists at Birmingham University, Prozac appeared to block changes in the brain's circuitry that lead to PMT-related irritability.
Study leader Dr Thelma Lovick told the British Science Festival in Birmingham: "PMS is an enormous problem, both for women and their partners.
"The solution could be as simple as taking a pill for a few days towards the end of women's menstrual cycles."
After the success of her experiments on rats, Dr Lovick now wants to test the drug on hundreds of women.
Since Prozac is already safety-tested and commonly prescribed, it could be made widely available as a PMT treatment in as little as two years.
IANS Millions of women now could be freed from the monthly misery of premenstrual syndrome (PMS) by taking a tiny dose of a common drug for a few days.
A major breakthrough has uncovered the cause of the debilitating cramps and mood swings that blight most women, reports express.co.uk.
Giving them a low dose of the common anti-depressant Prozac could stop PMS for good.
For the first time neuroscientists have found an organic cause for the condition when the levels of a female sex hormone changes.
Researchers at the University of Birmingham, led by Thelma Lovick, have shown that premenstrual-like symptoms can be triggered in female rats by a change in the level of secretion of one of the female sex hormones that normally occurs towards the end of the menstrual cycle in women.
In tests, the team found that PMS could be prevented by giving low doses of Prozac which is also known as fluoxetine.
Lovick said: "All that would be needed for countless women to benefit from what could be a simple and accessible treatment, involving a drug that is already in widespread use, is clinical tests to refine it and identify the optimal dosing strategy."
PMS causes pain and upset for millions of women worldwide.
Although not all women show all the symptoms, around 75 percent of women are thought to experience some of them.
These can include anxiety, mood swings, tiredness, depression, headaches, feeling bloated and pains in the joints. ~~~~~~~~~~~~~~~~~