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[MountainGal]

Hello, I've been prescribed a low dose (25mg) of Setraline, this was after taking HRT for two+ years and persoanally i don't feel its had effect. Earlier this year I lost my Dad and the lead up to that was quite traumatic as he had late stage cancer and it was very difficult to see his decline. From late July until 8 days ago I had episodes of sobbing, feeling sad, anxious you name it and the menopause made everything ten times worse. I'd tried everything from CBT, volunteering, walking in nature, meditation, herbals, hrt...I have a very supportive family around me and a good support network, I craft as well. So, it was encouragement from friends who were already on this medication who said I should just give it a try, as its not like I had tried every other avenue . I'm day six into taking 25mg and apart from some insomnia and feeling tired in the afternoon, oh and rather windy!! My mood has already lifted and no tearful episodes, which were so frequent it was wiping me out emotionally.
I think its quite possible that my serotonin levels were utterly depleted through anxiety which spilled over into low mood, tearfulness etc. My question is do I up the dose to 50mg which I'm due to do in a couple of days or stick with this for a few weeks and hopefully the minor side effects will wear off, tempted not to change something if its already working.

[SarahT]

Hello Mountain Gal, welcome,

I am so sorry for the loss of your dad earlier this year, I know how hard it is, I lost my mum this year and we nursed her in her last days so she could remain in the familiar surroundings of her home. do remember there is no cut off  date as such to be  recovering from grief,it's very individual your crying and pain is very natural as you begin to come to terms with things.
In a similar way I went back into an anti depressant this year, mainly due to horrific cyclical moods swings, I took the dose prescribed but felt it was far too strong for me, my sleep.was very erratic. So I immediately halved the suggested dose and have been on that for several months. It seems to suit me very well. And I know, i f need be so have options to increase if I need to.

If I were you, I would remain on the lower dose if it seems to suit your needs. I told my Dr about altering my dose down lower and they were happy with this. Perhaps you could do the same and have the security of knowing you can increase if your symptoms go down.I
It's good you also find other ways to help your moods. I wish you well x

[MountainGal]

Ah Thankyou, my Dad was so poorly in the end and he is now at peace, still miss him but perhaps an earlier healthier version. So sorry for your loss to. It seems to be a cruel time doesn't it, elderly parents, then menopause, if you have kids they are being grotty teenagers lol!! Very grateful for forums like this, I've only just discovered it!! I was on FB groups but trying to stay off social media. Thankyou for the advice re anti-d's, I do feel like its doing some emotional heavy lifting for me, like you the mood swings were wild, one minute fine next minute a sobbing mess!! i do think its more cyclical/hormonal than grief, I knew we were losing my Dad as he'd been given six months, so I went through alot of pre-emptative grief even before his passing, either way its never easy.x

[joziel]

I can't comment on the sertraline, but I just wanted to ask with the HRT you're on... Have you had a blood test to check you're absorbing it? And have you tried increasing the dose? Many women do need 400-600pmol of estrogen to feel at their best (according to my Newson doctor).

[Jules]

I haven't taken sertraline, it was offered to me though for anxiety. However my son has taken it for years. He also had CBT which helped. I would always consult your doctor about dosage just to be safe. My son tried to reduce his but under guidance. Medication gets a bad press, but it rescued my son from a desperate situation and he got back in step. My friend takes it for menopausal related anxiety. If she forgets a dose she feels low and has tearful episodes.

[CLKD]

So sorry for your loss, mayB making a journal about what you miss about your Dad and the things you did together?  Also it can take a while to settle into the absence of a person. 

As for Setraline, if it works at low dose then stick with that.  I've been on various ADs since 1988 with good results.  If I wake for more than 3 mornings in a row feeling extra low, I add 5mg to my 10mg at night and 5mg in the morning.  Until my mood rises to a comfortable level, my GP is OK with this regime.


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[MountainGal]

I can't comment on the sertraline, but I just wanted to ask with the HRT you're on... Have you had a blood test to check you're absorbing it? And have you tried increasing the dose? Many women do need 400-600pmol of estrogen to feel at their best (according to my Newson doctor).

I was on the maximum dose for estrogen, uestrogen originally but it wasn't doing much, I then had the mirena coil for progesterone but my body does not like the synthetic progestins, so I came off that. My body is absorbing after having a blood test it was at about 390pmol, but i ran out of places to put the gel on lol.

[MountainGal]

So sorry for your loss, mayB making a journal about what you miss about your Dad and the things you did together?  Also it can take a while to settle into the absence of a person. 

As for Setraline, if it works at low dose then stick with that.  I've been on various ADs since 1988 with good results.  If I wake for more than 3 mornings in a row feeling extra low, I add 5mg to my 10mg at night and 5mg in the morning.  Until my mood rises to a comfortable level, my GP is OK with this regime.


Browse round.  Join in.

Thankyou, that's helpful to know. I have been keeping a journal but more for my symptoms through menopause, I think I'm in a better place to start remembering the good stuff with my Dad, it was to raw before, grief is a weird beast to deal with!

[CLKD]

Ain't it just! 

Even now when I find my dog's collar etc., tucked away in a cupboard rarely used: my heart lurches.  And in recent months I've been thinking about my Dad more often [06.12.06]. 

There's no pathway for memories, good or bad.

Let us know how you get on.

[joziel]

mountaingal, there is no 'maximum' dose for estrogen - there is only a maximum *licensed* dose, which is an arbitrary thing decided by who knows what conservative doctors...

The reason there can't be a 'maximum' dose is because we all absorb it differently and what one person gets from 2 pumps might be the same as what another person absorbs from 6 pumps. So licencing it by what we apply to our skin is arbitrary...

Many women need much more estrogen than the 'maximum licenced dose'. And many women need much more than 390pmol before their symptoms go. My Newson meno doctor says most women need a serum level of 400-600pmol to be symptom-free and some women need it much higher than that, 1000pmol for eg. If you were only on the max licenced dose and your serum estrogen was 390, that was a bit premature to give up and ditch estrogen...

Finding places to put the gel can be difficult - I'm on 6 pumps of gel myself. I apply a pump to each inner thigh, a pump to each outer thigh and a pump on each butt cheek. On 4 pumps of gel, my estrogen was only 293pmol. I haven't tested yet at 6 pumps but will be...

If you need more than 6 pumps of gel, you can switch to Sandrena which is more concentrated and is a little sachet or two. Or there are patches, of course. (I didn't absorb well on patches either.)

But basically 1) there is no max dose. 2) you need at least 400-600 to be symptom-free (most women anyway) and some need more and 3) there are solutions with finding enough skin to apply it to...