What can I do about mood swings in the Peri-Menopausal Transition?

Very low-dose anti-depressants or anti-anxiety medications help with the emotional changes of peri-menopause and menopausal transition. My favorite drug in the world to use for this is a low dose of Prozac®. If you read the medical journals and textbooks, you always will see Effexor®, Paxil®, and Wellbutrin® discussed for menopause. I personally think that the doses that you have to start people on with these drugs are too high. Prozac®, or fluoxetine, is approved for PMS by the FDA (Food and Drug Administration), and it works great.   Prozac® has a bad name. No one wants to be on Prozac® because it is Prozac®. It was the first SSRI (selective serotonin re-uptake inhibitor) that came on the market, and in my opinion, it is the best one. It is cheap, and it is the only one approved for children and dogs. (Yes. Ask your veterinarian; they use it for depressed dogs.) I give my patients a very low dose of Prozac® for their menopausal symptoms, hot flashes, and mood swings. A normal starting adult dose is 20 mg/day.   I usually start my patients out on a 10 mg tablet that they break in half. If you think about it, they are not depressed but are overwhelmed with the changes that are happening to them. After about a month, I have them increase the dose to 10 mg/day if they are not any better. Most of the anti-depressants that we use for menopausal symptoms are capsules, or they don’t come in lower doses. I like to stay with this low dose of Prozac® for several reasons. The 10 mg dosage is a tablet that can be cut in half and this helps people wean off the drug when they are ready. It is hard to wean off of a capsule unless you just take it less often (i.e. every other day, then every third day, then every fourth day). Secondly, my patients don’t need the higher dose (which is indicated for depression). Lastly, on the low dose, they usually don’t have the side effects that can commonly occur with this class of drug.