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June 23/30, 1999

Clinical Crossroads: A 45-Year-Old Woman With Premenstrual Dysphoric Disorder

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(24):2283. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-24-jbk0623

To the Editor: In her Clinical Crossroads article, Dr Parry1 neglected 2 points. First, Thys-Jacobs et al2 reported that economical calcium supplementation (Tums E-X) reduced core premenstrual syndrome symptoms of negative affect by 48% in 466 patients. Neither the history nor discussion by Parry shed more light on this possible dietary variable and its interplay with this complex neurohormonal scenario.3 If the patient is now "kindling," this supplement could have been appropriate and, possibly, protective 2 to 3 years ago.

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