Severe PMS

I recently moved to the Chicago area and need some advice.  I would like to know a Dr. who would be able to improve my condition.  I have been taking meds for severe depression (possibly only PMS) for over six years.  For the last two years I have been taking Celexa, Wellbutrin and Alprazalom and the combo seems to work only for one week of the month.  However, for the last 7 years, two weeks prior to menses, my whole world changes and I am a mental wreck.  
Upon the advice of my current Dr. I have increased my meds upon the onset of any premenstrual symptoms, but this does not work.  During PMS time I usually will not leave my apartment, sleep most of the day, have angry fits, crying fits, thoughts of suicide and can become very aggressive.  Then like a new day is born, once my period arrives, I am renewed back to my self.  The  process of emotional changes evident throughout my menstrual cycle reduces my quality of life greatly.  I do not work now because once I reach two weeks into my cycle, for one week I sleep 12 to 14 hours per day with constant fatigue.  The next week is anger, rage and anxiety.  My previous employer was gracious enough to accept my condition and I set my own hours.  However, professionally speaking this makes me feel incapable.  Please let me know of any Dr.'s out there that might be able to help, any clinical trials, anything?  I am only 30yrs. old and just want my life back!  I look forward to your response.  

[HFHS.MD-AJ]

I am sorry to hear of the symptoms you report, which sound like Premenstrual Dysphoric Disorder (PMDD, also called Premenstrual Syndrome, PMS). Treatment usually includes support for sufferers of the disorder, progesterone supplementation, Prozac, and Alpraxolam (Xanax).

Henry Ford Health System is in Detroit. I suggest that you contact the Chicago branch of the American Psychiatric Association, for appropriate psychiatric referral.

[Amy]

What a lame answer.  I suffer the exact same problem which worsened after the birth of my second child and as I age.  Strangly enough, I had NO such problems during either of my pregnancy's.  How frustrating no-one can solve this problem.  I also have tried a variety of birth control pills with the attempt to stabilize my hormones.  My symptoms only grew worse.  The only thing I have found that makes a difference is Zoloft.  I have taken it for about the last 6 months, 100mg every day and have noticed a tremendous difference.  Side effects are minor but can be bothersome. For me they included insomnia at night and fatigue during the day, dry eyes (I wear contacts so this can be irritating) and minor irritable bowel which seems to improve over time.  The only problem I've found is that the positive effects of the drug seem to lessen over time.  My OBGyn has recommended I try taking the drug only  the last two weeks of the month.  I am going to try this and see what happens.  If you send me your email, I will keep you posted on results.  Other than that, I am trying to eat very healthy (very little simple sugar), lots of fresh/raw fruits and veggies and low fat protein.  Also, trying to include soy in my diet (tofu, soy nuts, soy milk etc) along with lots of whole grains (no white flours).  I also take a multi vitamin every day and take calcium supplements.  Excercise also helps a lot!   None of this is a cure, but with the research I've done over the years (and I've done a lot!!) this seems to be the best program for management I've used.  One last thing, TRY to reduce any stress in your life by either talking out problems with a therapist, getting back to nature, meditating, etc....  Stress exaserbates PMS terribly.  Hope this helps!  Feel free to write if I can be of more help.  Amy

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[sue]

This suggestion might be off the wall, but you could ask the doctors. I used to use a contraceptive called Depo Provera. I had the common side effect (or additional benefit) that I no longer had monthly periods. The birth control is in the form of a shot that you get every three months, which would be bad if you had an adverse reaction to it since you would have to wait three months for it to wear off, but perhaps it is available in another form. If the contraceptive were to eliminate your period, maybe you would not suffer so much.