Has anyone chosen to take antidepressants instead of HRT ?

[KangarooKenny]

I’ve very recently started HRT, but am very conflicted about it. My biggest complaint is not wanting to do things I used to like, such as holidays/days out/gigs. I’d rather not have the hassle and stay at home, where I like being. My dog is here, I’ve got a nice garden, country walks from my front door etc. And I know people have felt like this post covid, so I’m really not sure if it’s that, or peri.
So, has anyone taken antidepressants instead, what were your reasons for doing so, and how do you feel ?

Maybe give it a bit longer?

I’m not saying the HRT isn’t working, I’m asking if anyone chose antidepressants instead.

Yes me although I was taking them for the usual reason first. I have chosen to stay on them as they are helping.

I'm not sure what you're asking @KangarooKenny Are you saying that you feel anti-social and are not interested in the hassle of holidays? I don't think that is a sign of depression. I know loads of people who aren't fussed about holidays but they don't look at it as depression.

To use ADs, you would need a diagnosis of depression and also contraindications to HRT. It's not a case of asking for ADs.

No, I know that you can be offered AD’s in peri, as I was the other day by the GP, instead of HRT.
Im not having hot sweats and I sleep well, so it’s more the mental side of peri that affects me. Feeling sad and unsettled. So I wondered if anyone had tried AD’s

The NICE meno guidance says that ADs are only to be used in women with pre existing depression, not when it is likely that their moods are linked to loss of estrogen. Your GP is not following guidance and is out of date.

Read about this on the Balance app and website of Dr Louise Newson.

ADs have side effects and are not effective for peri meno symptoms except as an option for women who can't take HRT.

Medical guidance is to give your HRT at least 3 months and then reassess maybe with a higher dose if it's not totally working.

Thanks for you reply, but the GP said AD’s are licenced to be used.
So I’m looking for any women on here that might have used them for peri.
I know that you are very pro-HRT Jingling, but that’s not what I’m looking for.

@KangarooKenny This fact sheet explains it really well.

www.newsonhealth.co.uk/wp-content/uploads/2021/07/Antidepressants-and-menopause-v21-02.pdf

and a video!

www.balance-menopause.com/menopause-library/anti-depressants-and-the-menopause-with-sign-language/

Thanks, but she is making money out of pushing HRT.

I'm not pro HRT, I'm quoting medical information (don't shoot the messenger! Listen to the experts) . Have a listen/read of the links.

I don’t see the GP as an expert !
As I say, I’m not looking for an argument, just women who have tried AD’s for peri.

She is a medical dr. Please don't close your mind to science.

This thread has turned into what I didn’t want, I don’t want to discuss HRT on here.

You will find every menopause expert including menopause consultants are saying the same thing.

I don't have time to list them all, but maybe use your time today to read the advice of the British Menopause Society and other experts like Prof Nick Panay who works in the NHS! and who runs the biggest NHS menopause clinic in the UK.

I can relate to this but I just put it down to the fact I’m changing as a person. I was never overly social and now I’m content to be even less so. I’m on HRT and it seems to be balancing me out but I never feel super excited anymore or super sad, just sort of ‘middling’. I think the pandemic does play a part in how we feel and I’m early 50’s so ageing is a factor too. It’s hard to unpick the root cause of things sometimes. I you feel a persistent sadness then that to me suggests something needs further investigation and potential treatment. For me the HRT seems to have lifted the sad feeling but I’m not the person I was before. AD’s or HRT might be the answer for you. It’s horrid feeling sad all the time.

NICE guidance on HRT or ADs. Written 2015. GPs are supposed to follow it.

www.nice.org.uk/guidance/ng23/chapter/Recommendations#managing-short-term-menopausal-symptoms

Psychological symptoms
1.4.5 Consider HRT to alleviate low mood that arises as a result of the menopause.

1.4.6 Consider CBT to alleviate low mood or anxiety that arise as a result of the menopause.

1.4.7 Ensure that menopausal women and healthcare professionals involved in their care understand that there is no clear evidence for SSRIs or SNRIs to ease low mood in menopausal women who have not been diagnosed with depression (see the NICE guideline on depression in adults).

I visited the doctor approximately three years ago as I was suffering with chronic anxiety (I have always been an anxious person, but this was debilitating). Due to my age, we discussed the possibility of being perimenopausal, but as I was having no other symptoms we decided on a course of sertraline rather than HRT.
It did what I wanted it to do: took the edge of the anxiety. I feel like myself, but without the chronic anxiety. I'm on a low dose. It works for me. When it stops working - when I start getting other symptoms - then I will go back and we will re-evaluate . I have a review with the doctor every 6 to 12 months, just to make sure that the medication is still the right one for me.

Thank you.
I do wonder if it’s just getting older.
No, there’s no persistent sadness, I’m just not the person I was !

Thanks for your reply.

In a mums group for 17 years eight of us we used to have nights out which in the last few years morphed into lunch out we couldn't stay up that late. Post covid we arranged a couple of lunches which further lockdown stymied in Wales. We haven't tried to organise another one this year. We agree we've all become hermit like. So the flat feeling is a combination of age and covid I would say

Have a look at Dr Jen Gunter - she's on the socials and she has a book called the Menopause Manifesto. She has good, scientifically backed info about when anti-depressants are more appropriate than hrt, and what hrt won't help. Her view is very refreshing.

I’m sorry that I can’t answer your question but this stood out for me:

…not wanting to do things I used to like, such as holidays/days out/gigs. I’d rather not have the hassle and stay at home, where I like being. My dog is here, I’ve got a nice garden, country walks from my front door etc.

The things we enjoy don’t stay static. Holidays, days out and gigs are objectively more hassle and more expensive. UK holiday areas such as Cornwall have become overcrowded and more expensive since the pandemic. Airports are in chaos. There is still COVID around. Many people are re-evaluating if some of the things they used to enjoy doing pre-pandemic still bring them pleasure. Your pleasure in these activities may return again as life settles down or it may not.

Can you articulate why it bothers you? You clearly have things in your life you enjoy - your garden, dog, country walks. They sound great to me. You don’t sound especially depressed. I discovered during the pandemic that I am a real introvert and need more alone time. I am quite happy with that. Maybe there’s something around negotiating with friends and family who hold expectations for you that are based on the old you. Do you think there’s a worry that some relationships could change for the worse because of the change in you? I have lost a couple of friendships because we mainly used to go dancing and to festivals together. We are still happy to see each other if we meet in the street, but we don’t tend to meet any more.

@KangarooKenny I can't take take HRT due to cancer and I'm in surgical menopause. I take escitalopram; this was recommended to me by a menopause specialist. It is proven to help with hot flushes, as well as being an AD. For me it has been very positive as it as helped to get my bad anxiety and low mood under control and I do think it has taken the edge off the hot flushes which I was really struggling with. So for me it has been positive.

Best of luck whatever you decide.

I was prescribed fluoxetine by my GP for peri symptoms, particularly hot flushes and night sweats . At the time they were reluctant to prescribe HRT due to breast cancer within the family and fluoxetine was an alternative as in some cases it helps with those particular symptoms. I also had low mood so was happy to take it. I'm not sure it helped with the flushes in the end but it balanced out my mood nicely. I took it for maybe 18 months or so and then stopped as I felt that I didn't want to be on it long term and hoped that it might have just settled things.

Fast forward 5 years and I'm now menopausal but also have osteopenia so HRT has been suggested as they are now happy to prescribe it (even with the family breast cancer link) for a limited time. I would say my mood/anxiety could benefit from something too so I'm hoping the HRT will help with this.

Like you OP I can't get excited about doing anything or going anywhere, it all seems like a hassle. I've always been a bit of an introvert but even more so now.

If your symptoms are due to the peri menopause then the NICE guideline specifically say that antidepressants should NOT be prescribed. They will not replace the oestrogen that is depleting. Have a look at the Facebook group The Menopause Support Group, lots of information.

www.facebook.com/groups/384849495215750/?ref=share