Untreated, PMDD has the potential to destroy lives and relationships--I know this to be true. Had I not recently, and finally, found a woman doctor who prescribed Sarafem/prozac for severe PMDD (complicated by perimenopause--ugh!), I would probably be in divorce court. I hate my behavior during the 2-weeks of living hell and as I approached menopause, things were getting much worse. I have been on 10 mg of sarafem daily for 4 months now, and notice that the meds do not seem to be working quite as well during the 2-week PMDD timeframe. I am wondering if it is reasonable/safe to increase the does to 20 mg for the two weeks and then back off to the 10 on the other days, since it seems to be helping me overall...all the time. Anyone have experience with alternating this medication?