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[vintagefiend]

Hi I'm 44 and I posted a few days ago- basically experiencing anxiety/depression due to perimenopause (I assume- maybe i'm not quite there, hard to know!) and pmdd.
Have tried various hormonal treatments and zoladex but nothing has worked-
I cannot tolerate progestogen, I'm certain of that!
What's odd is that I coldn't tolerate 200mcg evorel patch either (high dose to suppress ovulation)- in fact had lots of palpitations on it which I thought was symptom of low oestrogen- I only stuck it for 3 days!
I'm on 40mg citalopram which is proving ineffective so am reluctantly going to try venlafaxine.
I'm reluctant because I really wanted to sort this with hormonal treatments- I'm certain that this is far more hormonal than mental health (though I realise the one leads to the other) and don't want to become reliant on antidepressants.
Does anyone have any ideas as to why hormonal treatments have failed for me? Are they likely to be more effective as I become more obviously menopausal?
Has anyone tried antidepressants, or a dual therapy of ant deps and hrt/birth control?
I feel that if I could suppress ovulation successfully my problems would not exist but i just can't seem to get there!
sorry i have repeated myself a bit-
 i've cut down the citalopram these last few days and i'm feeling pretty low...will be able to start venlafaxine soon.
i will email dr currie but she must be on holiday at the moment.
thanks for any responses.

[CLKD]

Feeling low with a lower dose of AD ………. how long does your GP suggest that you wean off before you start the other medication?  It took me 9 weeks of gradual reduction of dosage.

Little steps!

Let us know how you get on!

[anna123]

Hi,

Up until last week I was on citalopram and HRT. It is the only combination that has helped me and for the last 2 years I've felt 'normal'. I've had to come off HRT temporarily due to bleeding but that's another matter.

As I 've felt so emotionally well recently I decided to come off the citalopram about 2 months ago. It was awful. I was crying and an utter mess. It made me realize that the combination of the cit and HRT is what keeps me emotionally stable and if it works for me I will take it forever.

I'm physically struggling already being off the HRT though emotionally still feel stable, thankfully.

Dr Currie is excellent. I have seen her - if you are  in her area and can get a referral or see someone it woudl be worth it

[Hurdity]

Hi vintagefiend

Sorry to hear this and that you haven't managed yet to find a hormonal solution for a hormonal problem, that works for you.

The answer to your Q will it work better as you get further towards menopause is yes most likely -  because your own hormones won't be fluctuating. Unfortunately depending on how far you've got you might be dependent on ADs by then which you don't seem to want - understandably, if it is depression caused by hormones not an underlying issue.

Have you though of a CCP like Qlaira to suppress ovulation but give you an oestrogen type as in HRT? It does have a progestogen in it of course but seems to be better tolerated I think? Some on here have tried it. Side effects of any treatment are to be expected and you will read lots of stories of women getting bad side effects - of HRT and ADs initially but these settling after a while. Three days is a short time to try a new treatment.

I presume you've been to see a specialist judging by your treatments? It does sound like it's worth pursuing though to find the right hormonal treatment which you can then take long term. How were your periods doing before you started treatments?

Sorry I can't be of any more help - I know nothing about ADs as I've never taken them.

I wish you well anyway

Hurdity x

[vintagefiend]

Thanks so much for the responses- I really appreciate them. I still quite "wobbly" but do feel a little bit better today- had better night's sleep which always helps.

CLKD: the doctor suggested no more than two weeks for tapering off- I've only been on citalopram 40mg for about 2.5 months- in fact, my friend came off same amount citalopram and commenced venlafaxine in the space of 4 days- different doctors do different things, I guess!

ANNA123: sorry you had to come off the HRT and interesting that you were taking the dual therapy- i'm glad your emotions are stable on the cit- do u think u have underlying depression or has this all come about with the menopause? i know i'm a bit resistant to ADs but I'm sure if the venlafaxine works for me, i won't have an issue taking it! i can't claim to be a stranger to ADs- i've been on citalopram for some years but i was only on 10mg and was hoping to come off such a small amount...but then perimenopause hits and clearly i need them! i will def think about dr currie.

HURDITY: yes my feeling is that this is out of my normal scope of emotions- the hormones are most def responsible for the dreadful way i feel- however, i have had episodic depression and anxiety throughout adult life so i'm obviously susceptible- it's just i realise now that during those times i wasn't "so" bad- with treatmet i could socialise, hold down job etc. i guess if something gets me thru the meno-which could last years- then fair play but i do worry about coming off ADs at the other end- but the present is more important than what might happen, i guess. i have tried qlaira and felt dreadful! it's ridiculous but i just cannot handle hormones- i was on the pill in my 20s- no probs- hell, i was on cerazette in my 30s and no way could i handle that now! i will pursue the hormonal route but i'll get myself happy first of all on ADs and then perhaps i can weather the initial difficult bits of hormone treatment. Thank you all so much x

[CLKD]

Some ADs don't require weaning off at all!  I've changed from 1 kind to another with 24 hour break.  How have you been 2-day?

[vintagefiend]

Hi CLKD, thanks for checking in!
I'm better than i was yesterday- i couldn't have written a message yesterday, i felt so depressed- so i don't know if it's coming off the antidep or what!
i know what u mean re changing antidepressants but for some reason the gp was very keen that i stick to a tapering off regime...i'm v keen to get started on the venlafaxine but i'm trying to be a good girl!
i know that citalopram is an ssri whereas i think venflaxine is an snri so maybe they're different enough to warrant caution.
really appreciate your asking and i will update x

[CLKD]

As long as you find a medication which helps is the important aim!  They aren't always a 'cure' but taking ADs since the 1980s has enabled me  and I have to take them for Life.