Mine's a long story, but I hope it will help you.
Years ago, I took sertraline when I had PND and was fine with it, though I recall it made me slightly irritable and on edge. But that was far preferable to the dreadful anxiety and the pit of despair I had been in.
Like many PND sufferers, I suffered terribly with mood swings and anxiety again, as I entered peri menopause. It felt just like having PND again, but worse, and I didn't have a baby this time. Initially, my GP refused to believe my anxiety and depression could be peri hormonal, as I was only 43. But for the previous 2 years my PMS had got really evil, and my periods had become much lighter and shorter. So, my GP started me on sertraline, and OMG I reacted really badly to it. I didn't sleep a wink the first night I took it. I felt so trembly and agitated, and riddled with panic. I only lasted 25 days on it. I thought I was losing my mind.
Over the next 2 years I dragged myself down so many pathways in peri Hormonal Hell. I visited 2 more GPs. I tried a menopause clinic. I saw the specialist Dr Annie Evans. I tried Estradot patches, and Utrogestan. I tried 2 types of the BCP. I tried Femoston 1/10 & 2/10. But, the dreadful mood swings never stopped. I even saw the famous Prof. Studd and tried his magical estrogel + utrogestan + testim gel regime. But, I still kept finding myself back in the black pit of despair. I was alternatively terrified, or mentally exhausted. My sleep was really bad, and I would wake every morning at 4.30am filled with dread.
I ended up signed off work with anxiety/depression and under the care of the local Crisis Team, and their psychiatrist. The psychiatrist put me on Trazadone for the anxiety + a very low dose of Quetiapine to cure my awful insomnia. It didn't work. I just got worse. What followed were the worst 3 months of my life. I can't bear to remember how bad it was, and what I put my lovely DH through.
The crisis team were nice, but not much use. The psychiatrist never listened to me, and just kept upping the Trazadone and telling me to practice breathing techniques (wow, really great, thanks).
I started having constant black & bleak thoughts. In total desperation I rang Prof. Studd who told me to increase from 3 to 4 pumps of estrogel. Within 12 hours I felt an internal shift, and felt a little better. I enjoyed a couple of good weeks, then fell back into the pit. In desperation I stopped the Trazadone and went back to my GP who suggested giving sertraline another try and giving it at least 6 weeks. I cried because I remembered how awful it had made me feel 2 years previously. But I felt I had reached the end of the line, with everything else. I believe I had walked too far down the path that ultimately leads to suicide.
I took the first 50mg sertraline on June 26th last year. I was terrified. Within 8 hours my head had cleared a lot. After the 2nd tablet I felt really chilled out and sleepy. For the next 2 weeks I lay on the sofa a lot, just feeling quite dreamy. It was so wonderful. So wonderful. The tiredness was almost overwhelming, but I pushed on through it.
Over the next 2 months my GP increased me up to 100mg sertraline, which he said was the lowest therapeutic dose. My DH and family couldn't believe the change in me. I kept pinching myself, too. I was able to go back to work. I still had quite a few dark days, but the sertraline helped me through them. I was taking 5 steps forward, and 2 steps back, but every month I was improving and mentally brighter and stronger.
Since the start of the year, I have probably only had maybe 16-17 dark days? The rest of the days I feel at peace, and can smile and laugh again. I sleep well, and only wake at 4.30am to use the loo, and I go right back to sleep
So, sorry for the ramble, but I just wanted to show how dreadful hormones can make you feel, and that sometimes you have to kiss all the HRT & AD frogs before finally finding some sort of 'cure'. I think for some women, only the combination of HRT + an AD, and even something like Quetiapine, is necessary to wrestle your hormonal dragon into submission. I still lose some of the battles, but I do feel like I am winning the war