Silly? question about ADs prescribed for Menopause

[chuntersalot]

Brief History - I'm 48. Confirmed Peri in 2012. Symptoms ramped up in 2014. By the beginning of this year I was having multiple flushes daily, night sweats, interrupted sleep and palpitations. Last period 18 months ago. No medical reasons not to be prescribed HRT.

Have had several GP appointments, all but 1 reluctant to prescribe HRT. That GP wanted me to have a full blood screen to rule out any other causes - thyroid issues? Bloods came back and I was diagnosed Type 2 Diabetes. By the time I got through all the appointments about that the GP I had seen initially had moved on (locum).

In desperation I accepted a prescription for ADs (Venlafaxine, 37.5mg) from another GP. I've been taking them for nearly 4 weeks and they have reduced my symptoms but not significantly. Advice was to increase to 2 tablets a day if this was the case. I'm reluctant to do this.

So to the silly question - I'm not suffering from any depression, anxiety or stress. Only brief moments of stress / anxiety when experiencing a wave of flushes in work

What effect will the ADs have on my 'mood'?

If you take enough ADs your mood will be so buried that you won't give a toss about hot flushes, anxiety attacks etc.
Go back wave around a bit of paper about current HRT guidelines and get treated for your symptoms.

As the PP says, your GP is wrong. They are not working within current NICE guidelines. Read the NICE report- it's linked to on this forum all over the place or you can bring it up with google- and see the section about diagnosis and treatment.

It's made very clear that ADs have no place in the management of menopause symptoms without a clinical diagnosis of depression. GPs are told specifically NOT to dish them out for meno.

Thank you both

I'm so angry about this! I was offered ADs several times over the years! before I accepted the prescription. As I said in my OP I was feeling desperate. GP also told me these ones were also / mainly prescribed for 'Blood Pressure' - looks like that was a big fat lie, misdirection at best Just did a Google search on the AD prescribed and it seems it is also not recommended for people with Diabetes and I actually asked this specific question at the appointment - the GP couldn't have got it more wrong if he tried

Will be bringing my A Game and the NICE report to an appointment this week.

Some anger is good, it fuels you through the rough times.

Take facts with you, in note form if necessary. The internet is fecking brilliant isn't it, all that info that just needs sifting and filtering.
I find HRT can be brilliant, then I start getting a bit PMTish, so take a break for a few months and then go back to it. We are all a bit different, get what suits you.

My DM who has been taking venfalaxine for many years has recently been told by her GP that she should would like to review this as it's an old drug and there are much better options available now. I suspect it's cheap and that's why it was prescribed by her old GP.

You could also consider low carbing - it massively helped me with my symptoms. It will also help you with your diabetes.

BIWI - yes, I'm low carbing. Started the day I took the first AD so it could be that the improvement is due to low carbing and the ADs have not helped with the Meno symptoms at all?

4 weeks into a LCHF diet I am getting 'normal' Blood Glucose readings the majority of the time and have lost 4lbs. Had increased my exercise since March and have lost 14lbs in that time. My BMI is down to 25.09 from 29.0 My HbA1c was 67 at diagnosis and 69 at a repeat test 1 week later.

Pestilence - thanks for the link. Lucy - thanks for the sharing your Mums experience with this drug, the more I read about it the more I am realising that it definitely is not the one for me

ADs have a place for meno symptoms- see NICE- for those women who are unable to use HRT perhaps because of breast cancer or other diseases where HRT is unsafe.

You might find this helpful- guidance for GPs on HRT which is a Dummies' Guide to the NICE report. See page 4 for NOT giving out ADs. www.pcwhf.co.uk/documents/pcwhf_menopause_guidelines_2016.pdf

Just thought I would update.

Had an appointment with another GP who prescribed HRT. The appointment was largely uneventful apart from when the GP asked me if I was depressed - we shared a knowing look and a slight smile each. GP did try to go down the route of work place stress a little but right now I am in a relatively new job (4 months) and thoroughly enjoying it - GP accepted this and moved on.

I've been taking the HRT for 4 days now and already my flushes have reduced to I think just 3 yesterday The day before my appointment I had 17 and this was while taking the AD's.

In summary:

• I asked to be treated for the symptoms I did have, not those I didn't
• I took some printed pages from links provided in this thread - didn't need to refer to them much but took them out of my bag and had them on my lap
• Restated that I had accepted the AD prescription in and from desperation

Thank you all for your advice, I know it is early days but the HRT has already been more effective in 4 days than the ADs were in 4 weeks

That's great news- glad you got sorted.
I found the same re flushes- was experiencing them every hour on the hour all day long but within a few days of HRT they had gone.