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[Sallyyy]

I hope it’s ok to start a second thread in a few days.
I just wondered if anyone is taking antidepressants and finding helpful for severe anxiety plus depression.
I know the NICE guidelines say not to prescribe ADs for menopause but this is something I have had previously.
I’m 2 years past last period and had been very well on a v low dose AD for at least 10 years but have had an awful relapse.
Not sure if dose of AD was just too low to fight it off. Nothing happened. Was feeling fine and then came out of the blue.
Dr thinks not good idea to introduce HRT at the moment when everything so difficult and I agree but I may need to change AD if things don’t improve.
I’m not able to work at the moment and virtually housebound. Completely the opposite of my usual self. Very scared that I won’t get well again.
Would love to hear from anyone else who has overcome the same. I think one my fears at the moment is that ADs don’t work when oestrogen low in post menopause x

[CLKD]

Have you upped the dose of your regular anti-depressant?  When my brain feels low for more than 3 mornings I add 5mg to my regime: I take 10mg at night and usually 5mg each morning, the extra 5mg really helps within 3-5 mornings.  My GP is OK with this.

It may be that hormonal fluctuations are causing the alteration, however: trying an extra dose of AD first, then adding HRT if you require it. 

Why would you need HRT unless U are experiencing other symptoms?  One shouldn't immediately blame menopause for everything  although we do.

I was housebound for several months in the 1990s with anxiety: thought that I would never leave the house or go into our garden - gradually with ADs I recovered enough to improve my activities and these days am generally OK.  Especially when doing things spontaneously 

Try not to worry too much about leaving the house.  If you need to sleep, do so.  Sleep heals.  If you can listen to the radio, watch TV - though I could never follow a story line at that time - read .......... let us know how you get on.

This too will pass 

[Flossieteacake]

Please feel free to start as many threads as you wish too.

I would never manage without an AD. What I have found is, it can take a while to find one that suits. For me it helps to take the edge of my depression but does not get rid of it.

You will not always feel this way. You have had so much to deal with and it is bound to have had an effect on your mental health. I do not think there is any harm in trying an AD. Which one are you currently using and which dose? If the current one can be increased then that would be something to try.

I know when starting a new one you will need to taper off the current one first and that can be difficult but perhaps the DR can give you something to help ease the transition.

[Sallyyy]

Thank you replying. I was on a very low dose of clomipramine (18mg - standard dose is 50-100mg.)
It’s an old fashioned tricyclic.
I have slowly increased the dose back up to 50mg. Been on that dose for 12 days but no improvement yet.

It’s interesting that you say not everything down to menopause. Everywhere I look says to take HRT to sort it out but I have had different episodes of anxiety / depression.

[Flossieteacake]

Thank you replying. I was on a very low dose of clomipramine (18mg - standard dose is 50-100mg.)
It’s an old fashioned tricyclic.
I have slowly increased the dose back up to 50mg. Been on that dose for 12 days but no improvement yet.

It’s interesting that you say not everything down to menopause. Everywhere I look says to take HRT to sort it out but I have had different episodes of anxiety / depression.

I think they say you should feel an improvement for four weeks with antidepressants. Hopefully you will feel a change now that you have increased your dose.

[CLKD]

Who oversees your ADs etc.?

[Sallyyy]

My GP oversees the ADs. She is very nice but I think I may need to consider paying to see a psychiatrist. The NHS wait locally is very long.
Thank you for sending the kind messages. I can’t imagine feeling well again.
(I have increased the dose a couple of weeks ago @CLKD.)

Does anyone else take anti depressants ?

[VanillaLover]

Hi Sally

I will tell you my story… was on SSRI (Prozac) for years after birth of my first son…(he’s nearly 17 now). Felt well so decided to taper off really slowly. Like over a year. Sadly that was about the time that both the pandemic and peri hit. Plus in hindsight I think I cannot manage without an AD, I was kidding myself. I thought I would be “proving” something if I could get off it.

Anyway I was down to a super low dose and started to get bad cyclical moods and bad anxiety again.

Went back on the Prozac at my old dose. Nothing happened! Aaargh. Increased the dose. Still nothing happened.

At the time I was starting HRT due to hot flushes and was on a medium dose.

I decided to try an SNRI (venlafaxine) to try to improve mood and also address hot flushes at the same time (the HRT dose I was on helped but I was still struggling with them). Venlafaxine is also a first line treatment for hot flushes for those unable to use HRT. I was unhappy about starting a new AD (especially as SNRIs are difficult to stop) but didn’t have much other choice.

After a couple of weeks, massive improvement in mood on the lowest dose of venlafaxine. That was about 18 months ago now. Much more stable both mentally and hormone wise. I am still peri so not exactly the same situation as you I know. I also had CBT just before I decided to start the venlafaxine which helped enormously with the anxiety.

Can I ask - do you have any other menopausal symptoms? Hot flushes etc? Your mood change could well be to do with declining hormones but not definitely. Have you ever tried any other types of AD? It is possible for ADs to stop working as they should. Prozac is particularly well known for it. Has your GP discussed changing ?

Hoping you feel better soon. It’s the absolute pits I know.

[CLKD]

Morning.  I don't understand why people think that ADs are difficult to stop  .  Many years ago I weaned off 1 type in order to start another: it took 9 weeks of tapering.  Bounce back symptoms at each lower dose remained for 48 hours.  Once I realised that I didn't get worse as I tapered ......

Some ADs can be stopped over night.

I found over the years [since 1988] that if I tried the same AD it wouldn't work, probably because the brain was used to the 'recipe'.  Fortunately most of the medication kept my brain in order for 6+ years B4 poooping out  .  I have taken 10mg of escitalopram at night and 5mg in the morning for about 12 years now.

Prozac sent me   

Sallyyy - what dose AD are you taking?

[Losingtheplot]

Hi Sally

I will tell you my story… was on SSRI (Prozac) for years after birth of my first son…(he’s nearly 17 now). Felt well so decided to taper off really slowly. Like over a year. Sadly that was about the time that both the pandemic and peri hit. Plus in hindsight I think I cannot manage without an AD, I was kidding myself. I thought I would be “proving” something if I could get off it.

Anyway I was down to a super low dose and started to get bad cyclical moods and bad anxiety again.

Went back on the Prozac at my old dose. Nothing happened! Aaargh. Increased the dose. Still nothing happened.

At the time I was starting HRT due to hot flushes and was on a medium dose.

I decided to try an SNRI (venlafaxine) to try to improve mood and also address hot flushes at the same time (the HRT dose I was on helped but I was still struggling with them). Venlafaxine is also a first line treatment for hot flushes for those unable to use HRT. I was unhappy about starting a new AD (especially as SNRIs are difficult to stop) but didn’t have much other choice.

After a couple of weeks, massive improvement in mood on the lowest dose of venlafaxine. That was about 18 months ago now. Much more stable both mentally and hormone wise. I am still peri so not exactly the same situation as you I know. I also had CBT just before I decided to start the venlafaxine which helped enormously with the anxiety.

Can I ask - do you have any other menopausal symptoms? Hot flushes etc? Your mood change could well be to do with declining hormones but not definitely. Have you ever tried any other types of AD? It is possible for ADs to stop working as they should. Prozac is particularly well known for it. Has your GP discussed changing ?

Hoping you feel better soon. It’s the absolute pits I know.

Hi VanillaLover,

I too have used Prozac in the past for a number of years approx 20! After much trial and error and extreme crippling depression symptoms until I found the right Ad to help me.
I also stopped them last July (tapered down with GP advice)  and feel very similar to what you describe as in the timing of my stopping them coincided with drop in hormones although I felt stable without them until this year when peri/meno symptoms have increased.  I too feel like I possibly can't manage without an Ad as depression/bi polar/mental illness runs in my family (my dad).  I was fed up of the side effects too which was another reason I stopped them.   But I guess if we need them then we need them!  I am going to try Prozac again on a lower dosage and hope it helps me again like it has in the past.  I am pleased you found the right Ad for you and that it helps you.  Sorry for jumping in  but just wanted to share.

Sallyyy
I know if I increased my Ad's in the past it could take a few weeks before I could feel the effect of this could this be the case with you ?

[Kathleen]

Hello Sallyyy

I also take Venlafaxine which I was prescribed at the same time I started HRT. I was told that this AD is particularly good for reducing night sweats and I would agree with that.

I am post meno and I have tried many different HRT regimes and doses of HRT,  I even came off HRT completely for a while but I continue to take Venlafaxine.

I hope you find the help you need and I wish you well.

K.

[Sallyyy]

I am so so grateful for the replies to this post.
I have gone back up to 50mg of clomipramine it’s an old tricyclic.
I had been on 25mg for 10 yes and then 18mg for another 2 years and very well. Busy job / happy at home etc.

I was actually ok mentally through peri. I did have night sweats etc in my late 40’s but they seem to have reduced in last couple of years.

I had only relapsed in the past when I either stopped ADs completely or got below 20mg.

I am going to slowly increase to 75mg. You can take much higher on this medication but I have never managed to take more than 75mg.

Everything is very difficult and I’m not getting any respite. I can’t believe I was ok a few weeks ago.

Thank you for the info about other ADs. I’m very scared that I won’t be able to get well again.

GP happy to refer to psychiatry but said will be very long waiting list. Going to look to see if can get private appointment if no improvement in two weeks. Have been on the 50mg nearly two weeks now.

I really appreciate the support x

[Flossieteacake]

I am so so grateful for the replies to this post.
I have gone back up to 50mg of clomipramine it’s an old tricyclic.
I had been on 25mg for 10 yes and then 18mg for another 2 years and very well. Busy job / happy at home etc.

I was actually ok mentally through peri. I did have night sweats etc in my late 40’s but they seem to have reduced in last couple of years.

I had only relapsed in the past when I either stopped ADs completely or got below 20mg.

I am going to slowly increase to 75mg. You can take much higher on this medication but I have never managed to take more than 75mg.

Everything is very difficult and I’m not getting any respite. I can’t believe I was ok a few weeks ago.

Thank you for the info about other ADs. I’m very scared that I won’t be able to get well again.

GP happy to refer to psychiatry but said will be very long waiting list. Going to look to see if can get private appointment if no improvement in two weeks. Have been on the 50mg nearly two weeks now.

I really appreciate the support x

Good to hear you are going back on the Ad. I have taken Ads all my life and would not dream of trying to come off them. If they help then they can save lives.

So sorry to hear how difficult things are. I find it helps to take things one day at a time or I feel overwhelmed.

If you can book private therapy that will help so much and skip the waiting list too.

[CLKD]

This too will pass. 

I have both organic and clinical depression.  When my brain is low in the mornings for more than 3 days, I up to 5mg extra in the mornings.  After 3-4 days my brain feels better.

[Sallyyy]

Thank you
*flossieteacake* I hadn’t actually stopped the ADs - was on a low dose. I’ve been back on the increased dose for two weeks now but no sign of any improvement.
I am going to go up slightly higher (GP aware) and then give it another two weeks but after that may need to switch to a different one.
I really appreciate these messages. I had started to fear that now I’m two years into full menopause that this might be how I am now with no hope of getting better.
I’m trying to be rational and think that women must still improve on the right anti depressant at this age.