Dose increases can also make you feel worse before better. I have tried and failed increasing my citalopram from 10mg to 20mg. It is double the dose, perhaps that is why things aren't improving yet. When I looked on forums re citalopram, people were saying that sometimes the increase took them back to square one with side effects. I know with citalopram I lasted 5 days on the higher dose and I was so beside myself with anxiety that I couldn't continue. I increased the estrogel instead and that was an easier transition. If you are on highest dose of estrogen though, perhaps you could ask for a referral to a dedicated memopause clinic so they can explore other options with you.
Also, I find the progrsterone stage (am on utrogestan), particularly when I am coming off it, horrendous. Read its something to do with progrsteone increasing GABA and withdrawal then causing a sudden drop. I now use a supplement at that time called Biocare Calm Complex and it has helped with some aspects. Perhaps look at other natural ways of raising GABA and see if that helps. Some anti depressants also work on GABA levels, mine doesn't but perhaps yours does.
I hope you feel better soon. The psychological impact of peri has been by far the worst symptom I've had to deal with, so I know how you are feeling and I really sympathise.
