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Celexa - advice ( mostly PMDD related)

Posted by Jaynee on February 1, 2003, at 14:57:40

I have been on Celexa 10mg for about 5 days now and I am already feeling much better. I just read an article in New England Journal of Medicine that talked about Premenstrual Dysphoric Disorder. It talked about a study done with celexa and the "semi-intermittent"(a low dose during the follicular phase and a higher dose during the luteal phase), and intermittent (the full dose during the luteal phase only), apparently this worked best for PMDD, as opposed to continiuous dosing. Since my symptoms are worse during the week before my period, I am going to try the "semi-intermittent" dose.

I would like to try the "intermittent" dose, but I can't imagine doing this with Celexa. Wouldn't you get the withdrawal effects during the 2 weeks you aren't taking any Celexa. I could see how you could do this with Prozac, but Celexa?


Here is the study:

Selective serotonin reuptake inhibitors for premenstrual dysphoric disorder: the emerging gold standard?

Pearlstein T.

Department of Psychiatry and Human Behavior, Brown Medical School, Providence, Rhode Island, USA. Teri_Pearlstein@brown.edu

There have been a large number of studies conducted investigating the use of selective serotonin reuptake inhibitors (SSRIs) in the treatment of patients with premenstrual dysphoric disorder (PMDD). The 12 randomised, controlled trials with continuous dose administration of SSRIs and the eight randomised, controlled trials with luteal phase dose administration (from ovulation to menses) are reviewed. All the treatment studies on fluoxetine, sertraline, paroxetine and citalopram have reported positive efficacy. Fluoxetine and sertraline have the largest literature, with a smaller number of studies endorsing paroxetine and citalopram. Mixed efficacy results have been reported with fluvoxamine. In general, adverse effects from the use of SSRIs in women with PMDD are the usual mild and transient adverse effects from SSRIs including anxiety, dizziness, insomnia, sedation, nausea and headache. Sexual dysfunction and weight gain can be problematic long-term adverse effects of SSRIs, but these effects have not been systematically evaluated with long-term SSRI use in women with PMDD. Serotonergic antidepressants have differential superiority over nonserotonergic antidepressants in the treatment of PMDD. Treatments that enhance serotonergic action improve premenstrual irritability and dysphoria with a rapid onset of action, suggesting a different mechanism of action than in the treatment of depression. It is possible that neurosteroids, such as progesterone metabolites, are involved in the rapid action of serotonergic antidepressants in PMDD. Future research needs to address less frequent dose administration regimens, such as 'symptom-onset' dose administration, and the recommended length of treatment.


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poster:Jaynee thread:138759
URL: http://www.dr-bob.org/babble/20030130/msgs/138759.html