Clomiphene Citrate: The Valium of the 21st Century?

What a drag it is getting old!
Kids are different today," I hear every mother say,
Mother needs something today to calm her down.
And 'though she's not really ill, there's a little yellow pill
She goes running for the shelter of her mother's little helper.
And it helps her on her way, gets her through her busy day."
-- The Rolling Stones

In 1967, the Rolling Stones sang about prescription tranquilizer use in a deriding tone against the bourgeois over-thirty crowd. Later, Mick Jagger's generation went on to become the most avid users and abusers of illicit and prescribed drugs, and women in particular seemed the most vulnerable to the seductive qualities of prescription tranquilizers. They were easy to come by and often rumored to be non-addictive, while providing the benefit of calm in an increasingly complex world. By the mid-70s, diazepam (Valium) was the most widely prescribed drug in America, and women were the more likely candidates to receive these prescriptions.

The Fertile Panacea

Now, prescriptions for antidepressants (like Prozac and Zoloft) surpass the number of those for tranquilizers, and in the TTC crowd, it is commonly known that use of such medicines is best avoided. However, that same group of women who are anxiously seeking pregnancy are encountering another medical "panacea".

Each year, thousands of clomiphene citrate prescriptions are filled, the vast majority to women trying to conceive. Sold under brand names such as Clomid and Serophene, clomiphene is usually the first step in a series of drugs used to induce or enhance ovulation. Its advantages over the other drugs are obvious: taken in pill form (rather than injected) for just a few days, most report the possible immediate adverse effects are similar to PMS symptoms. Add to that the comparably low cost of clomiphene (average $35 compared to several hundred for injectables) and the compelling fact that incidence of multiples is very low (2% to 10% for twins and even lower for triplets or more), and it is easy to see why this drug is the usual introduction to infertility treatment.