Menopause and Premenstrual Syndrome relief agents

Three simple and sensitive spectrophotometric methods were developed and validated for determination of the hydrochloride salts of fluoxetine, sertraline, and paroxetine in their pharmaceutical dosage forms. These methods were based on the reaction of the N-alkylvinylamine formed from the interaction of the free secondary amino group in the investigated drugs and acetaldehyde with each of 3 haloquinones, i.e., chloranil, bromanil, and 2,3-dichloronaphthoquinone, to give colored vinylamino-substituted quinones. The colored products obtained with chloranil, bromanil, and 2,3-dichloronaphthoquinone exhibit absorption maxima at 665, 655, and 580 nm, respectively. The factors affecting the reactions were studied and optimized. Under the optimum reaction conditions, linear relationships with good correlation coefficients (0.9986-0.9999) were found between the absorbances and the concentrations of the investigated drugs in the range of 4-120 microg/mL. The limits of detection for the assays ranged from 1.19 to 2.98 microg/mL. The precision values of the methods were satisfactory; the relative standard deviations were 0.56-1.24%. The proposed methods were successfully applied to the determination of the 3 drugs in pure and pharmaceutical dosage forms with good accuracy; the recoveries ranged from 99.1 to 101.3% with standard deviations of 1.15-1.92%. The results compared favorably with those of reported methods.

Phytomedicine. 2003 May;10(4):348-57.
Chaste tree (Vitex agnus-castus)--pharmacology and clinical indications.
Wuttke W, Jarry H, Christoffel V, Spengler B, Seidlova-Wuttke D.
Department of Clinical and Experimental Endocrinology, University of Gottingen, Germany.
Extracts of the fruits of chaste tree (Vitex agnus castus = AC) are widely used to treat premenstrual symptoms. Double-blind placebo-controlled studies indicate that one of the most common premenstrual symptoms, i.e. premenstrual mastodynia (mastalgia) is beneficially influenced by an AC extract. In addition, numerous less rigidly controlled studies indicate that AC extracts have also beneficial effects on other psychic and somatic symptoms of the PMS. Premenstrual mastodynia is most likely due to a latent hyperprolactinemia, i.e. patients release more than physiologic amounts of prolactin in response to stressful situations and during deep sleep phases which appear to stimulate the mammary gland. Premenstrually this unphysiological prolactin release is so high that the serum prolactin levels often approach heights which are misinterpreted as prolactinomas. Since AC extracts were shown to have beneficial effects on premenstrual mastodynia serum prolactin levels in such patients were also studied in one double-blind, placebo-controlled clinical study. Serum prolactin levels were indeed reduced in the patients treated with the extract. The search for the prolactin-suppressive principle(s) yielded a number of compounds with dopaminergic properties: they bound to recombinant DA2-receptor protein and suppressed prolactin release from cultivated lactotrophs as well as in animal experiments. The search for the chemical identity of the dopaminergic compounds resulted in isolation of a number of diterpenes of which some clerodadienols were most important for the prolactin-suppressive effects. They were almost identical in their prolactin-suppressive properties than dopamine itself. Hence, it is concluded that dopaminergic compounds present in Vitex agnus castus are clinically the important compounds which improve premenstrual mastodynia and possibly also other symptoms of the premenstrual syndrome.

Br J Psychiatry. 1995 Aug;167(2):163-73.
Psychological and sexual symptoms associated with the menopause and the effects of hormone replacement therapy.
Pearce J, Hawton K, Blake F.
Littlemore Hospital, Oxford.

BACKGROUND. There is considerable inconsistency in the results of studies of the psychological and sexual sequelae of the menopause and their treatment. METHOD. A search of the literature on Medline was made of studies of psychological symptoms in women who were either naturally or surgically menopausal or who were receiving hormone replacement therapy for menopausal symptoms. RESULTS. There is evidence of a small increase in psychological morbidity (not usually amounting to psychiatric disorder) preceding the natural menopause and following the surgical menopause. Psychosocial as well as hormonal factors are relevant. While the response of psychosocial symptoms to hormone replacement therapy with oestrogens is variable and most marked in the surgical menopause, in some studies the effect is little greater than that for placebo. Where sexual symptoms are present, there is more consistent evidence that hormone replacement therapy is effective. CONCLUSIONS. In the light of the available evidence, the current use of hormone replacement therapy to treat psychological symptoms detected at the time of (but not necessarily therefore due to) the natural menopause must be questioned. It does appear that oestrogen therapy ameliorates psychological symptoms after surgical menopause.

The diagnosis, epidemiology, etiology, and treatment of premenstrual syndrome are reviewed. A relationship between depression and premenstrual syndrome is suggested by the increased prevalence of prior depressive episodes in women with premenstrual syndrome, common neurotransmitter and chronobiologic abnormalities, and the successful treatment of premenstrual syndrome with regimens used for depression. The relationship between menopause and depression is not clearly defined, but the perimenopausal years may be a time of increased depression for women who are at risk for depressive recurrences. The role of hormone replacement treatments in either ameliorating or promoting depression in menopausal women is a subject for future studies.