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Lilly Responds continued...

The very next sentence, however, offers this caveat: "The committee also advised that the drug should be used only to treat women whose symptoms are severe enough to interfere with functioning at work or school, or with social activities and relationships."

Miller also forwarded a "roundtable discussion" published in the Journal of Women's Health and Gender-Based Medicine, in which panelists from highly respected research centers in the U.S. and Canada conclude that "PMDD is a distinct entity with clinical biologic profiles dissimilar to those seen in other disorders. Thus, the relative safety and efficacy of potential treatments for PMDD can be evaluated, and, indeed many of those present thought that sufficient evidence is now available to support the use of [Prozac and similar antidepressants] in this disorder."

Natural Alternatives Also Work

"The vision of millions of women being put on this drug for a condition that can be so effectively treated in other ways is just stunning," Rosenthal says. "PMS is something that bothers a lot of women. There's no question about that, but it responds incredibly well -- and quickly -- to a combination of things, like vitamin B-6, magnesium, zinc, and the correct balance of proteins and carbohydrates in the diet."

In its marketing materials, Lilly draws a sharp distinction between PMS and PMDD, but others say the line is blurry, and that PMDD -- if it exists at all -- is really at the extreme end of a continuum representing the normal range of women's physiologic responses to hormonal variations.

"We need to give more credit to women for knowing what's going on in their own mind and bodies, and here we have a situation in which we have data quite conclusively showing that in this case women often do not know -- because it's OK for women to be crabby and because women don't allow themselves room to be sad, even if there are sad circumstances," Stotland says.

"And because psychiatric disorders are stigmatized, people who have just plain depression may not want to deal with that, and they have a tremendous tendency to blame it on PMS," she tells WebMD. "The dangers are that because women's hormonal changes happen to be in cycles, we forget that hormones have impact on men, and one might even say that we're neglecting men in that sense."

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