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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.

Second and of more concern is that St John's wort, a medicine used widely in Europe, was perhaps misrepresented. The National Institutes of Health are redundantly validating the experiences of clinicians.⁴ St John's wort was referred to by the consultant as a dangerous, "ineffective" agent because of "MAO [monoamine oxidase] inhibitor" action.¹ The source of this information about Hypericum perforatum (Greek, "to overcome an apparition") is unreferenced and perhaps overlooks . . . [Full Text of this Article]