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[lubylou]

Hi Taz,
It sounds like you have a supportive GP, the 10mg dose is therapeutic dose for anxiety (a higher dose is normally given for depression titrating up from 10 mg) so it sounds like your GP and the clinic are "on the case". If you have anxiety then the citalopram should help with this and who knows you might strike it lucky and find it also helps with the hot flashes as well.

I completely understand you reservations about starting because of the side effects, I have been through this process myself (with other types of medications). I am glad that I stuck it out because one I take now had dreadful side effects for the first few weeks and took a long time to titrate up to the therapeutic dose, but now the side effects have gone and this medication is a life saver for me.
 
I wish you luck.
Lubylou

[lubylou]

On the subject of anxiety, whether a meno symptom or a response to what life throws at us I have used mindfulness and it has been a life saver. It has taken be a long time to perfect the practise of mindfulness but it has been a vital part of my life in combating 24/7 pain and the associated anxiety and insomnia.

It is too complex to explain in a single post but if anyone is interested just Google "mindfulness" and you should find plenty of information on the web. The Breathworks website is a good starting point. http://www.breathworks-mindfulness.org.uk/

Lubylou

[Sarah2]

Dancing girl
I'm glad CBT helped you.
I think that the NHS currently offers 6 sessions. I know that the NHS has trained a huge number of nurses and other HP in CBT as it's supposed to be first line treatment now for depression along with counselling, rather than drugs. I do agree that you need to get on well with the therapist and this is individual rapport some of the time, as well as the fact that many NHS CBT people have had  short, fast track training rather than months or years of it.

[Taz2]

Thanks Lubylou - patience has never been one of my strong points and it's the thought of having to still go to work while feeling horrible that puts me off. I know I could take some time off but we are a very small team and stretched to the limit as it is.

She did say that she would start me on 10mg and then switch to 20mg as I get used to it. This is what happened to my son who has the same type of anxiety and he is doing really well on this particular anti depressant so I am hopeful - once I start taking it. I have been trying to find a "window" where I have nothing in particular to do in case I do feel ill.  She did say it could make my IBS worse for a while which cheered me up immensely!!

Taz x

[honeybun]

It sounds as if you have decided to give it a go Taz. It's just deciding when though as I suspect like me you can find any amount of reasons not to. Usually based on what you have to do for others and the fact you can't let people down.
I think this time you are going to have to put you first and let everyone get on with it while you get help for your anxiety. That includes your job too. It's not great to let anyone down but one thing I have learned is people do manage when they have no choice.
It's horrible when life becomes a struggle rather than a pleasure. It sucks you dry. We only walk this road once so we should try to make the most of it.
Says she who is the master of avoidance 
I really wish I could have tolerated the side effects. I could have been so much further forward now rather than just managing to keep afloat.
Maybe I gave in too quickly.

Good luck for whenever you decide to take that first pill.

Honeyb
x

[Taz2]

Thanks Honeyb - I do know that you have to give it a go for at least two weeks before you can really get rid of the side effects. The only one my son had was dreadful yawning but he switched to just before bedtime and that solved that problem although is girlfriend said he continued to yawn all night in his sleep!!

I have a friend who couldn't tolerate the effects of the SSRI but did well on SNRI's. Is that maybe an idea for you Honeyb?

Taz x

[honeybun]

Problem is I have got myself convinced that I am just not suited to this kind of thing. Totally irrational I know but all part and parcel of my anxiety.
I have always had gastric issues with pills. When I had my first baby I needed strong ABs as the surgeon cut my bladder by accident. Eventually they had to give them in pessary form as I was so sick. I have always been the same. Hence the reluctance to try again.
I am just a big coward who is going to have to find other ways of coping.

Really hope it works for you. You may well inspire me to try again.

Honeyb
x

[lubylou]

Taz, you have quite a dilemma to resolve about the timing of starting  the AD but I am sure you will work something out, the sooner you start the sooner you will get the benefit and see if it is going to help you. Taking a dose in the evening or bedtime and at the weekend could be a plan?

Honeyb, if you cannot get on with SSRis have you tried an old TCA called Amitriptyline? At a low dose it is used for pain relief but it is also used for its sedative properties. I take it for pain (as part of my pain med cocktail!). I did not notice any side effects apart from it increased the “noise level” of my tinnitus. I take a low dose and only take it when I know I am going to have a bad night. It usually makes me sleepy (but not always) and I find it is best taken a couple of hours before going to bed because the sedative effect takes a while to kick in and can last until the morning. It is also used as an off-label treatment for irritable bowel syndrome.  As I say, the only side effect I have is a temporary increase in tinnitus and it hasn't affected my digestive system. I know some people how use it as a sleep aid. Just a thought – you may have already tried it.

[Taz2]

It is difficult to find a time when there's not something that is looming on the horizon. I have a few gigs to go to in February so don't want to feel bad for those. Will give it some thought and then bite the bullet!

Taz x

[mamakaren]

It's really frustrating! I am one of those woman whose Dr just wanted to melon increasing my anti depressant instead of giving me more oestrogen.  I knew the ad wasn't working and she kept blowing  me off! I went back on Thursday and got a little pushy with her and finally I got a stronger patch prescribed. If this starts to improve my symptoms I'm going to decrease the ad until I'm completely off them. I'm feeling hopeful for the first time in almost a year of suffering!

Karen

[Hurdity]

There has been a lot happening on this thread over the weekend... and a lot of interesting discussion.

Taz - I'm pleased you were able to have a good discussion with your doctor about the whole issue of HRT and your situation. I tend to agree with what's been said re HRT and anxiety (ie the lack of oestrogen being a major factor) and also not letting the second window of opportunity pass you by.

However it is your body and your situation and from what you've said on here you have read and thought about it a great deal, and I imagine if your gut feeling said you wanted to go back on HRT I am sure you would argue your case strongly!  Also if you have suffered from anxiety in the past then maybe in your case lack of oestrogen may only partly be the problem?

I can see how you want to feel better immediately and perhpas the ADs will help with this in the short term and you maybe be able to re-start HRT if that's what you really want?

It is such a difficult thing though for us who are getting older - because those of us who do not like being on constant progesterone (due to side effects), do have to go through some sort of cycle for as long as it takes, or as long as we are on it, and this does get harder and harder as you get older so I can understand the dilemmas.

Whatever you do Taz I wish you well in your decision and hope you feel better as soon as possible - and especially so you can enjoy those gigs you mentioned below!

Re the NICE guidelines - it is the Menopause Guidelines Development group which is producing these. Here is the link:
http://guidance.nice.org.uk/index.jsp?action=byID&o=13891

The final scope of the guidelines which went out to consultation, have been published here
http://guidance.nice.org.uk/CG/Wave0/639/Scoping/Scope/pdf/English

There are two lay members of the group who will hopefully talk about women's experiences. I applied to become a member (there were two lay positions) but was unsuccessful.

Interesting to read the extract from the RCOG - which I haven't read yet but on another thread I posted the current guidelines about HRT which don't mention age as far as I can see ( haven't looked in depth - just the bit about stopping):
http://cks.nice.org.uk/menopause

Also the British Menopause Society  and Women's Health Concern statement last year (Nick Panay etc al) where they say the same thing re women over 60:
http://min.sagepub.com/content/19/2/59


It is great to be able to talk about all of this!!

Hurdity x

[lubylou]

I thought I would add to this thread a conversation I had recently with a friend. She had early menopause and was on HRT for 15 years. When she stopped she had no symptoms at all - none! So there are some of us for whom being on HRT for a good while and then stopping does not automatically mean the onslaught of menopausal symptoms.

Lubylou