PMS Depression

I have severe depression symptoms that are cyclic in nature; that is, they appear around the time of ovulation and last for a few days and then disappear (until next month).  The main symptom is crying -- I start crying for no real reason, sometimes even in public.  I am also more irritable and unable to sleep much.

My doctor said I was depressed and gave me Effexor, which helped but made me jittery so I stopped taking it after a week.  (No withdrawal, BTW -- I understand it can be a b*tch.) The thing is, I'm only 'depressed' for a few days out of each month.  I don't want to take Effexor every day when its side effects bother me.  However, the Effexor did help me on the days that I was PMSing -- I was not crying, for instance.

My question is: is there any type of medication that can be taken just a few days out of a month to help with this kind of cyclic depression?  It seems to me that most anti-depressants are prescribed long-term for each and every day.  Also, I know that many of them take a long time to have an effect.  The Effexor seemed to help me right away.

Thanks,
Anne

[HFHS MD - RG]

Dear Korillan,

PMS or currently known as PMDD or PreMenstrual Dysphoric Disorder may be treated with antidepressants belonging to the Selective Serotonin Reuptake Inhibitor (SSRI).

The latest information from published literature indicate that you may take the SSRI only during the luteal phase of your menstrual cycle. The luteal phase is the period of time(usually 11-14 days) following ovulation. This is provided you have a regular 28 day cycle. If not, this strategy is not recommended.

I suggest a consult with a Psychiatrist for an evaluation.

Sincerely,

HFHS MD - RG

[lc]

I just asked my gynecologist about this same problem, since I get very tearful, moody, and depressed immediately before and during my period. She told me that what she does is prescribe a low dosage of an antidepressant, such as Paxil or Wellbutrin, for the last two weeks of the patient's cycle.

My own experience has been that female doctors are better equipped to deal with their patients' PMS symptoms -- they've tended to take it more seriously than their male counterparts did.

Good luck with this -- I know it's no fun.