Main Research Findings

A combination of belladonna alkaloids, ergotamine tartrate, and phenobarbitone (Bellergal) was effective in treating troublesome symptoms of premenstrual syndrome, including fatigue, tender breasts, nervousness, irritability, lethargy, and listlessness, in a placebo-controlled, randomized, double-blind, parallel group study in hospital and general practice. The drug was given three times daily and caused no side effects. 2

A systematic review and meta-analysis investigated whether prophylactic administration of diphenhydramine reduces the incidence of neuroleptic adverse effects in patients with acute conditions. While the overall quality of evidence was low, diphenhydramine was associated with a significant reduction in extrapyramidal adverse effects compared to placebo. 1

A clinical comparison between thioridazine hydrochloride and a combination of phenobarbital and atropine sulfate found that thioridazine hydrochloride had fewer side effects.

Reasons for Side Effects

Side effects of belladonna alkaloid combinations and phenobarbital are likely due to the pharmacological actions of each component. Belladonna alkaloids inhibit the parasympathetic nervous system, leading to effects like increased heart rate, dilated pupils, and decreased salivary secretion. Ergotamine tartrate has vasoconstrictive properties and can cause headaches and nausea. Phenobarbital is a central nervous system depressant and can cause side effects like drowsiness, dizziness, and impaired concentration. 2

Common Side Effects

Drowsiness

Bellergal, containing phenobarbital, can cause drowsiness. 2

Dizziness

Bellergal, containing phenobarbital, can cause dizziness. 2

Impaired Concentration

Bellergal, containing phenobarbital, can cause impaired concentration. 2

Constipation

Bellergal, containing belladonna alkaloids, can cause constipation. 2

Dry Mouth

Bellergal, containing belladonna alkaloids, can cause dry mouth. 2

Blurred Vision

Bellergal, containing belladonna alkaloids, can cause blurred vision. 2

Rash

Bellergal can cause rash due to allergic reactions. 2

Indigestion

Bellergal can cause indigestion. 2

Side Effect Management

Drowsiness

Avoid driving or operating machinery if you experience drowsiness. 2

Dizziness

Be cautious when getting up or walking if you experience dizziness. 2

Impaired Concentration

Avoid driving or operating machinery if you experience impaired concentration. 2

Constipation

Consult a doctor if you experience constipation. 2

Dry Mouth

Drink plenty of water if you experience dry mouth. 2

Blurred Vision

Consult a doctor if you experience blurred vision. 2

Rash

Consult a doctor if you experience a rash. 2

Indigestion

Consult a doctor if you experience indigestion. 2

Comparison between Studies

Commonalities

All three studies evaluated the effectiveness of medications for PMS symptoms. 2 1

Differences

Studies varied in the specific medications investigated and the research designs employed. 2 1

Considerations for Real-World Application

While Bellergal may effectively alleviate PMS symptoms, it carries the risk of side effects. Consult a physician before using Bellergal and adhere to their instructions for taking it. 2

Limitations of Current Research

Research on PMS treatments remains insufficient. 2 1

Future Research Directions

Further research on PMS medications is needed, particularly focusing on long-term efficacy and side effect profiles. 2 1

Conclusion

Bellergal, a combination of belladonna alkaloids, ergotamine tartrate, and phenobarbital, is reported to alleviate PMS symptoms. However, it's crucial to consult a physician, as side effects are possible, and adhere to their instructions for taking it. 2

More research on PMS treatments is necessary. 2 1