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[Dee46]

Hi, I haven't been on here for a while but I was on Femoston 1/10 for 3 months & then GP upped me to Femoston 2/10 & have been on it almost 4 months, I am also taking 20mg citalopram which I think is making things worse, but would like some input as to if I should be feeling better now on the HRT, I had brown spotting for 10 days over xmas & then a week later got my periods, I am on month 4 of the progesterone part & still very tearful, last night I was sobbing as I feel so ill with the anxiety & dreaded thoughts, I still feel that the AD has made all this worse, I am currently thinking of changing the AD, my gp is useless so planning to go to see a meno specialist which I will pay for as I feel rotten & want some proper advice rather than being fobbed off with AD's which are not helping my mental health.

I also take my AD in the morning with my breakfast & wondered if taking at night might make me feel a little more human with less anxiety in the day?

Any advice would be grateful as I am struggling with feeling this way still after 7 months on HRT

[Dancinggirl]

Dee46
Treating the awful low mood and anxiety that often descends when meno hits is very difficult. HRT can only do so much - it's usually a range of strategies that eventually keeps things in balance. 
Did the low mood and anxiety start when you hit menopause or have you suffered with anxiety before?
Have you had PND in the past?
Do you feel this dreadful anxiety all the time or is it just when you are on the progesterone?
If you feel OK on the oestrogen part but anxious on the progesterone part then you may need to find a different type of progesterone - this can be tricky as even the most natural progesterone (Utrogestan) can still bring side effects.
The Citalopram is for depression and should be helping, but if it's not, then you may need either a higher dose or a different AD/SRRI. Many women need to try different ADs/SRRIs before finding something that works alongside HRT to control all meno symptoms.
Have you done any CBT?
If you are still peri meno ( which I think you are) then the higher dose of HRT may not be the right thing either - through my peri stage, a higher dose of oestrogen actually made me feel worse. 
If things aren't working then you do need a review of what your are taking. DG x

 

[Dee46]

Dancinggirl thanks for coming back to me

I do feel that my AD is not the right one for me, I was on pregablin & put straight onto an ssri, I was speaking to someone today who knows lots about AD & said I should not have been put straight onto it without a taper as they think that is what caused the panic attacks ( that is when the anxiety all started ) & the feeling not here like I was in some dark place, the thoughts were awful & insomnia, surely instead of the GP insisting I carry on with them they should have realised this?
I was a little low mood down to back/leg pain, but anxiety kicked in & I didn't feel myself, so no have never had depression after my 2 children or anxiety like this in my life until this all started & the AD I was given.
I feel the anxiety most of the time it is there in the background & feel like I am just a total wreck, on the progesterone I feel a bit zoned out
I feel better on the oestrogen but still a bit anxious & jittery, again could this be my body getting used to it?
I was on a higher dose of Citalopram & I had anxiety all day it was horrendous that is why I think this is the wrong AD for me, I am happy to try another AD but feel that SSRI's are not for me they just send me over the edge.
I had some private mindfulness which I put into practice & do my breathing but that is not always helpful when you feel so emotional
I have no idea where I am but guess I am in peri, I don't think I have felt better on anything to be honest since I started this journey hence the reason for seeing a private consultant to get the medication correct.

I have a relative in the same situation who is taking nothing so know that all this is hormonal but I am sick of not knowing when I will start to feel a bit like I was before, it is so destroying 

[Dancinggirl]

Dee46 - From what you are saying, I think your instincts are right about the citalopram - like most drugs it's about finding the one that suits and maybe your don't need the AD at all - you would need to slowly taper off over time so ask how to do this and then you can see if things improve.  If you feel worse without the citalopram then perhaps try a different SRRI.   I also wonder if you are on too high a dose of HRT as well - if you are still peri meno your own hormones will be fluctuating in the background and possibly going back to the lower dose might be a consideration. I would try coming off the Citalopram first.  Good that you do Mindfulness - I find this brilliant.
Femoston has one of the kinder progesterones so, unless you feel the progesterone is giving you really bad PMT while you are taking it, I would stick this type of HRT for now.  Don't change everything at once - it's about withdrawing one thing at a time to assess how you feel - try to be logical about it if you can.  If your GP is really useless perhaps move to a different GP within the practise or even a different GP practise if you can - but do your research.  Paying privately is one way to go but that can be hit and miss.
It is about trial and error and the peri stage is particularly challenging because of the fluctuating hormones but you sound a sensible person and you just need to take time to sort this - be patient.
It is staggering how the meno messes with our heads - nobody warns us about this and it can be life changing.  The peri stage can be particularly challenging but meno is called ‘The Change' with good reason and we do need to embrace certain changes and here on MM we can help and support with this.  Keep us posted  DG x

[Mojo61]

Dee, I'm also on citalopram and HRT and I'm not sure what's doing what with regards to my anxiety and low moods. It's a bloody nightmare and I really feel for you.

Talking about nightmares - do you get really vivid dreams every night?

[Dee46]

Mojo61, do you feel any better being on both Citalopram & HRT? Have you tried any other AD's? Your right it is a bloody nightmare & I just want to feel a bit of reality but it seems so far off, I know they say the menopause is temporary but trying all these tablets seems to go on forever when you feel rubbish

I don't really get any vivid dreams, I was sleeping about 2hrs a night this time last year but managing to get about 6 hours so that is the only thing I feel better about, can I ask if you take your AD & HRT at the same time of the day? Just thinking of changing my AD to night time to see if I feel less anxiety the next day.

[Mojo61]

Hi Dee. Yes, I've been on citalopram now since 2nd April 2016 and HRT since the end of Feb 2016.

I'm certainly better than I was, I just couldn't cope and insisted that my GP refer me to the CMHT because I honestly thought I was going insane. Sadly they dismissed me after a 3hr assessment saying that I didn't meet their service "criteria" so cheerio basically. I have been left to struggle on alone since then...

I did try a few others right back at the start but with each one I could only ever tolerate the first 2 or 3 tablets such was my anxiety, and then I would give up. In the end I knew I had to do something so I went right back to the first meds I was ever prescribed (and had only taken 2) - citalopram, stated on 10mg for 3 months and then increased to 20mg. I can now work and socialise again, but they haven't been the panacea I was hoping for sadly. I was expecting to take them and be back to "normal" within about a month or so. That didn't happen and I'm still struggling but nowhere near as bad as I was.

Can I ask, do you get days, or sometimes weeks, of not feeling too bad only to then be hit with a massive setback? That's what seems to be happening to me.

What are your worst symptoms?

[CLKD]

Why did your GP prescribe Citalopram? - they are not a 'cure' but a way of managing symptoms.

HRT can take 5-6 months B4 the lady notices any benefit, particularly if her own hormones are joining in the party   

[Dee46]

Mojo61

I agree I am better than I was a year ago, panic attacks were so bad even through the night, head was throbbing & I honestly thought I was dying I also thought what has happened to me why have I turned into this mad manic woman that is sobbing & shaking like a leaf all day, it was horrendous. I also self referred myself to the NHS for cbt after seeing a poster at work but they turned me away too!!! So had to pay for some private counselling.

I feel like going back on Amitriptyline as I had them before all this anxiety set in, I was only on 25mg but that was for nerve pain although I think it was the start of all this peri meno, I agree it has not been like that either for me, I was told by my GP that women used AD for the menopause so took her word & carried on with them hoping it would help the anxiety it gave me!!

I get the 'odd' day where I feel not too bad, last week I almost felt normal again to then go back to feeling rubbish again the next day, it happens to me too, then all of a sudden it gets too much & I end up sobbing at work or when I get home.

My worst symptoms are the palpitations & tight chest, shaking, burning tongue, head going to explode, basically just feeling that I am going to be like this forever & what is the point. What are your worst symptoms Mojo61?

CLKD - my GP prescribed them as I was put on sertraline as I started having panic attacks & he thought I was stressed, they send me into some weird dark place, came off them after 2 weeks & anxiety was so bad I went back to GP & they put me on Citalopram, been on them since & they do not make anything any better, in fact I think they make things worse.

I get confused as some say min 3 months to feel any benefit, I take it that is 5-6 months on each dose of HRT to feel the benefit? I have been on this dose for almost 4 months

[CLKD]

3 months is usually muted as it is several 'cycles' of treatment.  For me, it took 6-9 months of taking ADs to realise that actually, I was beginning to feel better 

[Hurdity]

I agree it is difficult to tell what's what - with ADs, high dose of HRT and peri-menopause all thrown together with hormone surges and crashes. I agree with Dancinggirl if you are only just starting the peri-menopause journey the dose might be too high - and ADs may well just be clouding the issue. We are not going to feel good all the time during this stage - whatever we take - so being able to recognise the down parts of our cycle and moods and finding strategies to cope and be positive is really the way to go rather than forever searching for that magic medication that's going to cure-all, unless you are in danger mentally - of not coping at all to the point of instability. If you are sobbing on the AD then I would taper off it and try to find the best HRT that suits you first before deciding that you need something else.

If you are progesterone intolerant (ie if these feelings mainly occur on the prog part - then you definitely do not want a different medication to cure the effects of another type! Have you thought of trying a different HRT type? - Oh I see Dancinggirl already suggested this way down the bottom of this thread - the first reply!

Hurdity x

[4candles]

Hello Dee46
I'm not really able to comment on the HRT situation with you, since I have only very recently started it myself (in the hope of alleviating both physical symptoms and mental health deterioration .. I've posted in the New Members section, which gives an idea of the kind of things going on with me).
However, I just wanted to offer a little of my personal experience of anti-depressants. First of all though, were you on Pregabalin for long and at what kind of dose? You probably know that, as well as being a pain medication, it can be very helpful for anxiety (I took it for a short while) so I wonder if you are having withdrawal symptoms from it? I agree that it would have been best to taper it.
Some a/ds do (at first) cause the very symptoms they are supposed to alleviate, especially as the levels build up in the body. Have you been on the Citalopram for long? Everyone is affected so individually by each medication, but generally, the SSRIs need a good 6-8 weeks to build up to full effectiveness to see if they are actually helping. It can be hard hanging in there when you are so desperate to feel better. I take Cipralex (in the morning) which isn't dissimilar to Citalopram and is supposed to ease anxiety (whereas Prozac made me all jittery). I think the Menopause, in my case, has thrown a colossal spanner in the works  and I do wonder whether the hormonal apocalypse has impacted on the efficacy of the anti-deps (i.e: they don't seem to be doing much).

You could try asking your GP to refer you to the Mental Health Team for an assessment. Sometimes you have to really state you are desperate in order to get the wheels in motion.

If and when a/ds start to help, the improvements can be very gradual and subtle, so do bear that in mind. Also, if you go on to another one, ask if you need to taper the dose of the old one or cross-taper on to new one. Going on to a new one may well be like starting from scratch. If you stop an a/d altogether, never be tempted to go 'cold turkey', and, if you've been on them for years, the tapering has to be very very slow indeed. Usually much slower than is generally recommended to allow the brain, which has adapted to the A/D, to cope with the change.

Deary me, why do things have to be so complicated

I do hope you find some helpful professionals to point you in the right direction soon. X

[Mojo61]

Hi Dee, I would say my worst symptom is just feeling so bloody WEIRD all day! Difficult to explain but it's like the old me has gone, and a new different me has taken over my body. I remember back to a time when I felt normal, happy, never gave anxiety a thought. If I woke up in the middle of the night and couldn't get back to sleep then it was just a pain in the backside, I didn't analyse every minute detail of WHY I had woken up and what impact it may have on me for the following day. I wasn't constantly scanning my body to see how I felt, I didn't dread the weekends like I do now.... Oh what I wouldn't give to go back to those carefree days.

Hope you are feeling a little bit better today x