Your a great parent, your aware that things are not right and your looking for a solution, good for you
![Wink ;)](https://www.menopausematters.co.uk/forum/Smileys/extended/wink.gif)
You can go back to the doc and ask for one of the low dose tablet options in the following:
http://www.menopausematters.co.uk/perimeno.phpI really hope that the doc listens to you this next time you go.
If you don't want AD's then
Tell the doc you don't want to be on AD's.
Explain that you'd like that to be made clear on your notes also and ensure the doc states that your not taking the new ones.
Remember you might still have to taper off your use of citalopram over a few weeks.
A lot of people do not realize that some AD's could affect them driving or doing other things we need to be alert for.
If an insurance claim was made later then it might have some impact.
Has your doc warned you of that for Effexor, I'd guess they have not?
If your doc continues to deny your request for HRT instead of AD's,
then politely ask for them to make clear why they are refusing your right to ask for a particular drug to help you.
You could suggest that they do this in writing also as your finding it a bit hard to understand why in the short duration of your appointment.
As long as your firm and polite there should be no reason why the doctor can refuse.
Alternatives to help if the doc refuses again:
1) ask to be referred to a meno clinic so you take the decision out of the docs hands
2) look up on the web if you've a meno clinic near by and phone and see if they need a referral (not sure as its not the route i took myself but others have mentioned it)
3) I'm assuming your maybe not on the pill? If you were then sometimes that can flatten out the high's and low's you'll have through early peri. You can either ask the doc to put you back on a monophasic/28day contraceptive pill. Just emphasize your still worried about that and want to be sure as "your not in peri" according to doc!
![Grin ;D](https://www.menopausematters.co.uk/forum/Smileys/extended/grin.gif)
4) If doc refuses to prescribe pill even, then get yourself down to the nearest family planning clinic (if your in the uk). They should be able to prescribe the pill to see if that helps bypassing your doc.
5) Go private as others on the forum have done but obviously this could prove an expense.
Hope that helps you a bit further.
![Kiss :-*](https://www.menopausematters.co.uk/forum/Smileys/extended/kiss.gif)