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[Lesley49]

Good morning ladies

I am new to the forum and would like to share my story.

My periods stopped 5 years ago.  About 5 years before that I felt my hormones were changing dramatically and I ended up taking Fluoxetine for anxiety.  At that time I never even considered this to be peri menopause as I had been through a mentally abusive relationship and just thought it was the after effects of that that had made me panicky and anxious all of the time.  I had an awful few. On this but eventually came through that and after 3 months off work I went back and was Ok again.  Shortly after that I met my wonderful husband and we married 6 years ago.  I am really happy and content and was living life to the full

Then about 2 months ago I started to feel dizzy - like vertigo feelings - I then had what I now know to be a panic attack at work which really frightened me,  I went to see my GP who ordered blood tests to see if there was anything phyisically wrong.  These came back clear. 

Up to the dizzy feelings I had been doing everything, cycling to work part time, walking the dog straight after and then to the gym 4 times a week and then cooking tea befor eventually plonking myself down about 7 pm.  I never relaxed but didn't see this as a problem - until now!!  My father was then taken ill at my house and ended up in hospital for a week being tested for everything's!!  This was a shock as although he's 83 he's always been so fit and active.  Anyway I was ok through his illness and thankfully now he's fine again and back to his usual self.  About 2 weeks after this I started to feel anxious and have been feeling that way now for about 3 weeks.  I called my GP and I asked her whether HRT would help me.  She said maybe and proceeded to prescribe Kliovance over the telephone. 
 
I took the HRT for a few days but felt my anxiety was getting worse and I was so tearful so telephoned the surgery yet again and was prescribed Sertraline to help,with the anxiousness and also the tearfulness.  I was given a 50 mg dose and took the first one that afternoon.  I felt great for about 6 hours and felt I was cured!!  How wrong I was - I started feeling dreadful with a massive rush of adrenaline and dizziness.  I had a sleepless anxious night and telephoned the surgery the following day (even though by this stage I thought they must think I am going mad!).  The doctor said I could be having a strong reaction to the Setraline and advised me to reduce the dose to 25 mg for a few weeks until my body got used to it.  I took the 25 mg for a few days and then took 3/4 of a tablet but yet again felt dreadful.  I was then advised to reduce back down to 25 mgs for a while.  I went to see my doctor last week after eventually being able to get an appointment.  She advised me that Sertraline is a very good drug for anxiety and that I should stick with it.  She said to carry on taking the HRT as this was just adding a little estrogen and wouldn't react with the Sertraline.  She said I should stay on 25 mg Sertraline for now.

I have now taken the A/D for 2 weeks but still feel awful - if anything I feel worse - I was so tearful this morning I told my husband I didn't know how I felt and that I felt I would never be well and back to my usual happy go lucky self.  I just wondered if anyone else has taken Sertraline for anxiety during the menopause and if so how long it took to feel better - also did it make anyone feel "strange" to,say the least?  I'm at my wits end and feel like I'm going mad again.  Can anyone reassure me?

Thanks ladies

Sorry to go on ladies but wondered if anyone can relate to any of my experience.  I am sure this is menopausal but do you all agree?   

[Dancinggirl]

I do hope someone will be along to advice soon.  I haven't ever taken ADs/SRRIs so haven't experienced what they are like.  I do understand that it is very common to actually feel far worse for the first 2-4 weeks on any AD/SRRI before you start to feel better - is there not an information leaflet with the drug?  It does annoy me that GPs don't warn about the side effects of ADs/SRRIs but are very quick to warn everyone about the possible side effects of HRT. Many women do find the combination of HRT with a SRRI really good.  However, some CBT might have been a good route to try and possibly a different HRT - in my experience we simply have to take life at a different pace as we progress deeper into meno - I have to practise a lot of Mindful Meditation to control my anxiety and low mood.  To expect HRT or any drug to sort things is simply unrealistic. Kliovance is a conti HRt so gives you progesterone every day and this can have a negative effect on mood.  Unfortunately the alternative is a sequential HRT which means you would get a monthly bleed which many women don't want in post meno.
I suspect you will need to persevere with the Sertraline for a couple more weeks before you get the benefits.
Keep us posted.  DG x

[Mary G]

Welcome to MM and sorry you have been having a difficult time.

Firstly, I'm afraid I don't have any experience with ADs or anxiety medication but there are plenty of others on MM who can help with that.

However, I do have experience with HRT.  I have never used Kliovance but I have used norethisterone which is used in the progesterone part of Kliovance.  I've just been writing about my experience on another thread (this member was taking Kliovance and has since stopped) and this is what I said:

"If it's any consolation, I had a horrendous experience with norethisterone and had 5 attacks of silent migraine (scintillating scotoma) in one day.  If that wasn't bad enough, the wretched stuff stayed in my system for ages afterwards, so much so, when I started the progesterone cycle the following month and was forced to cop out after just 1 x 2.5mg tablet (migraine kicked in within hours) I still had a completely normal period, with a normal flow and a normal scan result - the experience was so bad, I had to be checked out afterwards.  It was truly dreadful and I would rather have a full hysterectomy now, this very afternoon, than ever face that again.  I realise this might be described as an extreme case but nevertheless, it is an example of what this stuff can do - bear in mind I don't have form when it comes to PMS or gynaecological problems and I had not suffered from migraines pre-menopause."

I'm not sure how helpful this will be for you but it does give you some idea of what norethisterone is capable of if you are sensitive to synthetic progesterone as I am.

In your situation, I would suggest you try and change to a different type of HRT.  Kliovance is pretty heavy duty with a lot of progesterone and early indications show you are not getting on very well with it.  I found continuous progesterone gave me a feeling of constant low mood and took away all the positive effects of the oestrogen.  I don't rate oral HRT either because I found it caused digestive problems and I was not absorbing enough oestrogen.

There are far better HRT products around but you would need to decide whether or not you want to have periods again.  The problem with HRT is the progesterone component which can cause low mood and side effects.  Generally speaking, oestrogen = feeling great, progesterone = not feeling great and side effects for many women.

I am severely intolerant to all types of synthetic progesterone and to micronised progesterone (Utrogestan) in high doses so after much trial and error, I now use transdermal, bio identical cyclical HRT which consists of Oestrogel, Utrogestan (progesterone for 7 days each month) and a small bead of testosterone.  This does mean having periods but it is a small price to pay for feeling normal again. 

Why not have a look at the treatment section on here to get an idea of the type of HRT that might suit you?  You can always come back and ask questions.

I hope that helps.

[CLKD]

 

Maybe your whole system is over-run with medication?  Have a browse using the 'search' button for Setraline to see how other ladies have found it?

I had awful side effects with ADs in the early 1990s, eventually my GP found something that worked.  PHEW! 

Let us know how you get on!

[Tempest]

Believe me when I tell you that I have researched this subject of AD's in menopause a LOT over the last week or so!

I actually came across a scholarly articles that explained that women with low levels of hormones do not respond as well to AD's as they would have done when their hormone levels were optimal. A lot is going on with the brain as hormones are essential to healthy brain function, and AD's don't work the same when a woman's hormone levels are low leading to 'unfavourable outcomes', according to the study.

I also found the answer why women feel hightened anxiety often when increasing heir estrogen - especially if the dose change is large or hormone levels are very low. Estrogen increases norepinephrine in the brain, and this sudden surge causes all those jittery, anxious feelings. It's like 'fight or flight' on steroids.

I hope this info helps in some way - maybe it can help you to make sense of what is going on for you right now. I am personally adopting the 'start low and go slow' approach now to raising my estrogen levels to try to minimise the jittering, but it is agonisingly slow when all you want is relief!

[kew]

I take Sertraline for anxiety and have been on it for about 3 months. I had nausea for about a week and then was ok.  In my case it has done what it was supposed to do and that was to keep me calm. I'm also taking hrt which I started first, felt great and then after a few months where I had some health scares I was naturally anxious.  However when everything was over the anxiety stayed and I seemed to be this sobbing wreck everyday.  Hence the Sertraline.  After the nausea I did find that each day got better to the point that I actually looked forward to taking the tablet.

Now though I'd like to stop taking them. I like the calm that they bring but I just feel a bit dead underneath it all, no passion or energy for anything. The doc has recommended that I stay on them for 6 months and start to gradually reduce. Am just hoping that once I start to reduce them I will start to feel like me again. 

Everything I read about Sertraline and side effects seemed to be bad and I was terrified initially, but then I came across one website where every one seemed to say stick with it and it does get better, and they were right up to a point. I can only suggest that you stick with it, it may well be the combination of two new drugs in your body that's giving this reaction.  When I started Hrt I'd been on it 3-4 months before I started with Sertraline.  The hrt gave me a few side effects and racing heart/palpitations but these settled eventually. Hang in there 

[Tempest]

CLKD, can I ask what worked for you? Just in case I need to go down that road (I know we're all different though).

SSRI's do the beast to me! I've only ever got along with old tricyclics in the past.

[Justjules]

Hi Lesley. I had a horrific time on Sertraline unfortunately. I had always taken Citalopram before with no problems but Sertraline was awful for me. Some people swear by it and if you are anxious any side affects are heightened but I tried to stick it out for 6 weeks but that was it. It's hit and miss with ADs....what suits some doesn't suit others because we are all different in our brain chemistry. Sorry to be so negative but that was my experience.

[CLKD]

I've had several, names long gone from the memory.  I'll have a look at the packet later so that I give you the correct name, it's 5mg at night and 5mg in the morning, plus a betablocka ………

[babyjane]

I actually came across a scholarly articles that explained that women with low levels of hormones do not respond as well to AD's as they would have done when their hormone levels were optimal. A lot is going on with the brain as hormones are essential to healthy brain function, and AD's don't work the same when a woman's hormone levels are low leading to 'unfavourable outcomes', according to the study.

I don't completely agree with what this study says.  I don't know what my hormone levels are as I have never had the levels tested but I am approaching 60 and post meno so they can't be all that high.  I am having no trouble with the low dose AD I take and it has been, and still is, very helpful.  However years ago, when I was still in perimeno, I did not get on at all well with an AD.

[Hurdity]

Hi Lesley49

You haven't said how old you are but that has some bearing on the dose of HRT. If you are under the natural average age of menopause you may find actually that the dose of oestrogen you are taking is just not sufficient to lift your mood. Also I totally agree with Mary G and Dancinggirl about the continuous progestogen (norethisterone) causing side effects in some women.

Also if your periods had stopped 5 years previously then your body has been starved of oestrogen ie it will be pretty low so you were probably reacting to a sudden surge of these. What a pity you were given ADs in the first place when you were peri-menopausal - as you yourself said, your hormones were changing dramatically.

The worst thing is - you have been given an HRT that may have made the problem worse and then you have been given an AD for the anxiety which could be caused by the type of HRT!!!

Please do read up about the different types of hRT and try a different type - Femoston is a much better tolerated tablet HRT if you want to continue with tablets. It comes in sequential (withdrawal bleed) or continuous combined - but if you are young the continuous one is also low dose (as the Kliovance).

If you are say mid-late 50's then I would suggest starting with a low dose patch like Estradot 25 mcg and utrogestan as the progesterone - but ideally on a longer cycle if you can get a gynae GP to prescribe this for you. Alternatively there are some women on here trying femseven conti patches cut in half - although this is still continuous progestogen, and you could build up to a full patch.

My feeling is though that you need to work up to a higher dose of transdermal oestrogen (patch or gel) and keep progesterone to a minimum. Ideally you should be able to wean off the ADs if your anxiety is hormonal and you can find a regime where you feel better for most of the time.

Hurdity x