To take Sertraline 10 days before period (PMDD)

[blackbettybramblejam]

I’ve been suffering with PMDD for a long time and I think it’s getting worse. I don’t want to live like this and I certainly don’t want my family to have to live like this.
Ten days before my period comes on I am anxious therefore snappy/ angry and depressed. It’s hell.
I tried Sertraline in the past but it stopped me from being able to orgasm and cry so I came off it.
But I’m wondering if I just took it for the ten days leading up to my period, I’d only be on it for 1/3 of the month so it wouldn’t be so bad in terms of side affects?

I'm really not an expert but wouldn't you have all the awful side effects of starting and stopping every month? Why not speak to your GP to see if there is a better medication.

A friend did this with Prozac and it was wonderful. Obviously under medical supervision.

It's an SSRI so it won't work in ten days - it needs two weeks to get into your system properly. You need to take a more old fashioned anti depressant I think for it to have a more instant effect. Speak to your GP as they will be able to advise.

I am almost certain this is a terrible idea. Nobody really knows exactly how SSRIs work to improve symptoms of depression and related affective disorders in some people, but what medicine has established very well is that SSRIs take several weeks or months to work (for example, my sister slowly tapered to her therapeutic dose of 150mg over 12 weeks and it wasn't until about week 14 or 16 that she started to really notice the anxiolytic effects). Also, notably, SSRIs have significant side effects, particularly during the first 2-4 weeks of use and especially when SSRIs are stopped. Even with careful, slow tapering some people experience withdrawal symptoms for months, so stopping taking them abruptly (and then resuming a few weeks later, on repeat) seems like a recipe for all the negatives and none of the positives.

Emotion regulation & distress tolerance techniques from CBT might be more useful for you in managing PMDD symptoms.

Sertraline is used in this way and I was prescribed it that way. I'm on it full time at the moment as that's what I needed. GP was happy for me to use intermittently. Speak to them.

@ipodtherforipoor

Sertraline is used in this way and I was prescribed it that way. I'm on it full time at the moment as that's what I needed. GP was happy for me to use intermittently. Speak to them.

It's not ideal.

In addition to my own post above, see: pubmed.ncbi.nlm.nih.gov/11563834/
Alpay, F.B. and Turhan, N.O., 2001. Intermittent versus continuous sertraline therapy in the treatment of premenstrual dysphoric disorders. International journal of fertility and women's medicine, 46(4), pp. 228-231.

Specifically, this part sticks out:
Out of 162 PMDD-positive patients 94 accepted medical treatment; 71 patients were given sertraline on a continuous basis, and 23 patients took sertraline intermittently in the luteal phase of the cycle. Because of side effects, 44 (62%) of the continuous therapy and 22 (96%) of the intermittent therapy group stopped medication. At the end of 6-month follow-up, continuous use of sertraline was found to be significantly more tolerated than intermittent therapy in the treatment of PMDD (chi2 = 7.88, p = 0.005).

If OP has previously had intolerable side effects from continuous sertaline, intermittent sertraline is unlikely to be the answer, since its side effects are even more intolerable.

Thank you for these thoughtful answers all.
Ahh I hate my hormones!!

It really needs to build up in your system then remain stable, what dose were you on? It can go down to 25mg so maybe a lower dose

My GP suggested this approach but with citalopram- maybe talk to your dr about trying that?

I have spoken to my gp and they do recommend taking it just for the 10 days leading up to my period so I’m nervous if doing this and having to assimilate each month but I felt so dead inside taking it all the time.

I’m on sertraline and for me, I think taking it on/off like that would just lead to more up and down moods and make me feel worse overall. I feel it even if I’ve just missed one day’s medication. So I don’t think it’s a good idea

I tried it years ago, pmdd sufferer too, it didn't work, I felt worse it messed my mind up.
It might help to take half the dose, increase to double 12 days before.
I think they are great.
I'm on 50mg all month suffering at the moment slight moments of a rage but easy settled, they take the darkness from the illness for me. Vitamon B with exercise too.
You feel like a new person after a month. Side effects are obvious for one month.

From the NICE guidelines for PMS:

cks.nice.org.uk/topics/premenstrual-syndrome/management/management/#management

"For women with severe PMS:

Consider prescribing a selective serotonin reuptake inhibitor (SSRI, off-label use) to be taken continuously or just during the luteal phase (for example days 15–28 of the menstrual cycle, depending on its length). In people younger than 18 years of age, prescribe an SSRI only on the advice of a specialist. Do not prescribe an SSRI if there is doubt about the diagnosis or a lack of experience in prescribing them.
Give an initial trial of 3 months' treatment; if there is benefit, continue treatment for 6 months to 1 year. Suggested doses are fluoxetine 20 mg a day, sertraline 50 mg to 100 mg a day, citalopram 20 mg a day, escitalopram 20 mg a day, or paroxetine 20 mg a day."

Thanks all.