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Prozac for PMS
If the drug can do for monthly mood swings what it is said to do for depression, bring it on, baby!

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By Stephen Bloom

July 18, 2000 | Q: Why don't men have PMS?

A: What's the point? They act that way all the time.




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Q: What does PMS stand for?

A: Putting up with Men's Shit.

Lighten up, girls. The news that the FDA earlier this month approved the use of Prozac to treat severe symptoms of PMS struck me as one of the great leaps of modern medicine, right up there with penicillin and Dramamine. Premenstrual syndrome has been the bane of women (and men) since Cleopatra. How else to explain the queen's wild rants and mood swings, going from the world's hottest seductress to the baddest bitch west of the Nile?

Is it any wonder that the fiercest female pro-wrestling tag team in the WWF goes by the name PMS? The two wannabe Xena warrior princesses seem to symbolize their PMS-afflicted sisters everywhere. When interviewed by TV announcer Michael Cole, Terri teasingly began to disrobe Cole, then Jackie kicked him in the groin.

Prozac is a wonder drug. If it can do for PMS what it is supposed to do for depression, then bring it on, baby!

But what about gender equality? If a woman gets cranky, she can always blame PMS. When a guy gets moody, it's evil testosterone surges or his macho-flawed personality. Now, women get to take a pill, leave the dishes in the sink, say hasta la vista to Jason and Jennifer arguing over who's going to get voted off the island on "Survivor," and then soak in an herbal bubble bath while inhaling scents from citrus, rose-petal and almond candles.

Maybe it's a way to get back for Viagra.

As anyone over 16 should know, PMS can be characterized by extreme, often irrational behavior that includes eating binges, sudden anger, irritability, impulsive behavior and the desire to punch somebody (anybody) out. Many men report a snapping, snarling nature that seems to take over their usually simpatica mates for anywhere from one to two weeks before the monthly onset of menstruation. Wise husbands and boyfriends know never to assume -- or at least, never to say -- that PMS is the cause of their partners' rank moods. It is not a good idea to ask in the middle of an argument, "Hey, what gives? You got PMS again?"

To help cope, there used to be Midol. (A no-brainer: Midol was a subliminal message to mean "My Doll.") But that was ineffective for anything but mild cramps.

Several years ago, husband-and-wife scientists at MIT came up with a powder drink they trademarked as PMS Escape. The potion contains carbohydrates and vitamins that its makers said helps PMS sufferers cope with the carbo cravings and precipitous plunge in brain serotonin levels that many women experience during the weeks before menstruation.

Then came Prozac.

The first randomized, double-blind, controlled trials of Prozac on women with PMS were done at eight Canadian hospitals in the early 1990s, and reported in the New England Journal of Medicine in 1995. The results were staggering: The 313 women who took Prozac showed four to six times more improvement than those who took placebos. In other clinical trials, 75 percent of women showed improvement with Prozac or similar drugs.

Since then, many physicians have prescribed Prozac (and other antidepressants) off-label for women with severe PMS. All that was missing was the Food and Drug Administration's formal approval so that Prozac's manufacturer, Eli Lilly and Co., could niche-market the world's top-selling antidepressant directly to premenstrual women. That approval came July 6, when the FDA formally cleared Prozac as a recognized PMS treatment.

So that it can jump-start sales and distinguish the PMS therapy from the antidepressant, Lilly will not call the PMS product Prozac, but rename the identical compound Sarafem.

How's that for feminine-sounding? I can see the TV ads: earth tones, Martha Stewart-style scenery, close-up of doting but obviously preoccupied mother (Joan Lunden lookalike) with child (girl) in designer kitchen (sub-zero refrigerator, Corian countertops, GE Profile stovetop), voice-over of caring doctor (female) gently hawking Sarafem ("for those times of the month when women need something extra") and a fade to twin smiles while kneeling and removing steaming cake from oven.

To complete the makeover, the new PMS drug will not come in Prozac's signature capsule of lettuce-green and cream colors, but in dreamy, comforting lilac-and-blue. Sarafem should be in pharmacies next month, says Lilly spokeswoman (of course) Laura Miller.

. Next page | PMS is no joke
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