Hi Gladys Bananas
Sorry to hear about all your issues - but taking all those meds! No wonder you poor body is protesting.
It's difficult to know what to advise - except the two most important things and I agree with CLKD here - HRT should help with hormonally induced mood changes and is the first line of treatment, not the other meds, and that the Lorazepam should not be taken regularly as it is highly addictive and very difficult to come off.
I would take a step back and try to work out what caused your problems initially. What has led you to take Citalopram - was this due to depression caused by life circumstances or do you think it was originally hormonal? Were your original problems for example occurring cyclically? I also wonder if the progestogen from the mirena may cause some depressive symptoms but if you had to start taking the Citalopram before you first had one fitted then this is unlikely. The problem with the Mirena is that it often stops periods (and I presume this was the case with you?) so you no longer have a strong cycle to be able to say that hormones are definitely responsible for your mood changes.
However it sounds like your recent issues are definitely hormonal as you are the right age for this - so to give you the Lora... and beta blockers rather than HRT is not the way to go long term and I can understand your frustration with this treatment.
Personally I would try to get off the Lora... asap and if you must, reserve them for emergency use. Ditto the beat-blockers - this is a heart medication so slows you down and your heart, lowers blood pressure etc etc. I mean we shouldn't need these if your heart is healthy!!! There are other non medication ways of dealing with anxiety - lots of strategies - mindful meditation, behavioural strategies, websites like nomorepanic etc which would be preferable.
Re HRT - I haven't heard of Estorial type HRT so maybe you are not in UK? There should be an HRT type that agrees with you - but the problem is as you don't know where you are in menopause (due to the Mirena) then it is difficult to get the dose right and if you are peri-menopausal, then you may well be having dramatic oestrogen surges and plummets. A low dose transdermal HRT might be the way to go - like an oestrogen patch for example ( maybe this is what you tried) but building up gradually. Unfortunately while you are peri-menopausal if your cycle is still carrying on then you willl still experience mood changes but the Citolapram should help with these.
The oestrogen HRT should eliminate the flushes and sweats but I would really try to stop the other meds if you can.
Just to reiterate - oestrogen itself does not cause depression - rather the opposite - but your underlying cycle (where oestrogen drops suddenly) could cause you to feel those symptoms.
Sorry this is a bit of a ramble but hope it has given you something to think about and maybe see if you can try to get off the medication treadmill - which it sounds like you would rather do.
Hurdity x