The development of the psychiatric diagnosis pmdd and the marketing of sarafem as its treatment, menstrual the main problem i have with this work is that, although fingerson admits in chapter 1 that readers should not read full source.

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SNRIs and SSRIsincluding fluoxetinemay increase the risk of bleeding reactionsConcomitant use of aspirinnonsteroidal anti-inflammatory drugswarfarinand other anti-coagulants may add to this riskCase reports and epidemiological studiescase-control and cohort designhave demonstrated an association between use of drugs that interfere with serotonin reuptake and the occurrence of gastrointestinal bleedingBleeding reactions related to SNRIs and SSRIs use have ranged from ecchymoseshematomasepistaxisand petechiae to life-threatening hemorrhages.

There have been reports of both increased and decreased lithium levels when lithium was used concomitantly with fluoxetineCases of lithium toxicity and increased serotonergic effects have been reportedLithium levels should be monitored when these drugs are administered concomitantly.

BMay be acceptableEither animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

Patients should be advised to notify their physician if they intend to breastfeed an infant during therapyBecause fluoxetine is excreted in human milknursing while taking SARAFEM is not recommendedsee Use in Specific Populations

1 Personality disorder is the COSTART term for designating non-aggressive objectionable behavior2 Adjusted for gender.

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