Antidepressants for peri/menopause?

[Crankylanky]

Doctor has offered me escitaprolam for anxiety and depression. I’m peri menopausal / menopausal . Been researching and some sites say antidepressants don’t help hormonal related mental health. Others do. (And actually it may not just be hormone related- think I’ve always had anxiety and at times depression, just never been treated before). What I’m confused by is the fact that SSRI’s really seem to help with PMDD . And that is obviously a hormonal condition. So following on that logic , surely they’d be beneficial for peri menopause too? Anyone on them and thinks they help?

I do appreciate that there is a need for anti Ds for some people, and for serious depression, but there has been a LOT in the media over the past month about worryingly high over-prescribing and GPs handing them out too quickly and when not appropriate. There is a lot of concern about the millions of people being put on meds when some are just experiencing normal (but uncomfortable) emotions.
(These are the points in the reports- I'm just relaying them.)

The point that was made is it's almost impossible for a GP in a short consultation to decide if anxiety is 'normal' - most people suffer from anxiety at some level, and it doesn't require treatment and would get a 'tick' in the list of questions a GP asks.

For some time now, the NICE guidance (not solely for women in peri) has been for GPs to offer talking therapies like CBT and counselling rather than drugs. The idea is to get to what is behind the anxiety and for patients to learn to manage it with coping strategies, learned through CBT exercises.

The guidance for menopause is clear and it's unfair for GPs to offer ADs as first line treatment, without a referral to a psychiatrist, which is what NICE says.

These are the reports that came out 3 weeks ago.

[[https://futurecarecapital.org.uk/latest/reducing-antidepressants-through-social-prescribing/#:~:text=NHS%20plans%20to%20reduce%20antidepressant%20use%20through%20social%20prescribing,-The%20NHS%20pl

[[https://www.pulsetoday.co.uk/news/clinical-areas/mental-health-and-addiction/gps-asked-to-further-cut-addictive-medicines-prescribing-after-450k-script-decline/

Menopause is also a time where masking for those that are neurodivergent (where they know they are or don't - and many women don't) becomes much more difficult/impossible.

Not disputing that there may be an over prescribing of ADs but there will be some cases where menopause is not the cause of anxiety but has instead removed the hormones that helped keep it in check / mask it.

Doctors seem to lack training in ND (esp recognising in women) as well as menopause.

Ooh - that’s fascinating!

I'm not an expert - just researching this myself atm as I suspect I'm ND and going through perimenopause is what first started me questioning this. I'm on HRT and it's been really helpful in some respects but I'm in the highest standard dose for oestrogen and still feel incredibly anxious at times. Trying mediation and exercise for now but will see about ADs / other meds if that doesn't help significantly.

What do you define as neurodivergent?
Asperger's? ADHD? Autism? Dyslexia?

All of the above

It might help to have some professional assessments. Have you thought about this? Ask your GP for a referral for the autism symptoms, but an ed psych would diagnose dyslexia. (you'd have to pay for that.)

I wasn't posting to ask advice about me (but thank you diagnosis is something I'm considering but waiting lists are long and I'm not sure yet of the benefit) more to share in case might be useful for someone else.

Also don't consider I have all those ND conditions you mentioned - I was just answering that yes they are all ND.

Ah okay! Sorry. I know about ND ( professional work.)