Anyone else been prescribed sertraline

[Joanne73460]

I've been on everol 50 sequi since last October I felt great for a couple of months then all my symptoms returned my GP wouldn't up my dose so referred me to a menopause specialist I've been on the waiting list since March and still waiting for an appointment spoke with GP this week about my anxiety getting worse I get overwhelmed with everyday tasks terrible brain fogging etc so he has prescribed me sertraline he said hopefully just until hrt gets sorted with specialist but I'm nervous about starting them as you can't just come back off them because of the withdrawal and there's other side effects I'm worried about anyone help with this or experienced anything with these

Sorry but it's hard to understand why your gp won't increase your dose. The next step is more estrogen- either 75 or 100 patches.

Your dr sounds incompetent.

SSRIs are not prescribed for meno symptoms (NICE guidance.

Can you go back and see another GP? There is no reason at all to stop him prescribing a higher dose and it's just wasting your time and that of the meno clinic to send you there with something so basic.

Thank you that's pretty much exactly what I said but he said it's not as simple or straight forward as upping the dose although he said my anxiety etc is definitely down to menopause and nothing else I just think they can't be bothered so fob me off but it says in the referral letter that they prefer your GP to try at least 2 separate doses/types of hrt before an appointment can be made so he obviously hasn't read that I've spoken to 2 other drs in the same practice one was female and didn't have any empathy or experience in this field and kept insisting I didn't need contraception as she believed I am in full menopause going by my blood tests even though I told her I'd had a random period so I had to go to family planning clinic for the mini-pill and I was told I could have it for one more year she said I should be on continuous as I'm not having regular periods and the random period I had was a side effect of the sequi patches she said if I bleed again I'll need a scan to check things out so that was a bit scary but GP just seems to ignore what I said

What a load of nonsense!

I think you need to go back to your first GP and really push the advice you have from the menopause clinic that another dose has to be tried first.

but it says in the referral letter that they prefer your GP to try at least 2 separate doses/types of hrt before an appointment can be made so he obviously hasn't read that

Take him this letter.

You also need to be on sequi HRT if you had a period within the last year.

It's such an obvious thing to put right and they are making a complete drama out of it.

the local pharmacist suggested I try sertraline for meno-anxiety and it has worked really well. I have been on a very low dose and it took the edge off just enough for me to function and I've had no side-effects at all.

I don't know about HRT as I've not been on it, just wanted to let you know that sertraline can be very helpful so might be worth considering.

My gp was quick to offer me sertraline for meno symptoms, but i refused & kept on until someone listened.
I also had breakthrough bleeds on the patches, evorel conti but was told to Continue with continious regime as the bleeds were brought on by the estrogen changes.
Keep nagging for increase or a change. Good luck

I am on a low dose sertraline and a high dose 100 patch HRT. Both keep me feeling good.

Meant to say that I started on 50 patches, then 75 and now 100. Each time symptoms started to come back so I called the pharmacist at our surgery who can prescribe. Can you try that?

NICE guidance says very clearly that SSRIs are not appropriate for menopause unless women cannot use HRT. They appear not to work (often it's a placebo effect) and Dr Louise Newson has many leaflets on this on her website.

GPs have been asked not to offer them.

They have side effects too, regardless of whether they work or not.

@Joanne73460 I do hope that menopause clinics feed back to GPs who refer patients unnecessarily. It is very frustrating for women who desperately need advice for more complex issues and wait months for an appt, yet GPs are sending women to clinics for something as simple as an increase in the dose.

Also wondering if I do decide to take it if it's best taken at night in case of drowsiness or during the day in case of insomnia also as I've been lucky that menopause hasn't affected my libido and have a pretty good sex life will sertraline affect either libido or reaching orgasm would hate to lose even more feelings and thanks for all the great advice

I take mine first thing (to avoid the risk of adding to meno-related insomnia) and it's had no effect in either direction on my libido, it's the same as it has always been.

I take Sertraline for meno related anxiety. It was crippling and Sertraline really helps. I wasn’t on HRT when I first went on it. Am now on HRT as well and doing well with both. It hasn’t affected libido.

You might like to watch BBC Panorama today on this.

A lot of growing concerns on the use of ADs and long term risks, including withdrawal symptoms.

ADs are not recommended for meno anxiety. The firs type of treatment to be tried is HRT, clearly stated in the NICE guidance. Sadly, many GPs seem unaware of this.

Did anyone watch the programme on antidepressants? Was it useful?

Yes, I watched it :)

It was quite damning of the effects of ADs on some people.

The main point was that many ADs are addictive including sertraline.

The trials of the drugs were based on usage for 6 months. They don't know much about long term side effects but they may cause heart issues and diabetes.

Over 2million people in the UK have been on them for over 5 years. Some people (on the programme) were taking 5 years to get off them and were addicted. (Including one mental health doctor himself.)

1 in 4 women are on them.

When people stop, they think their symptoms are coming back. But for many people the symptoms are actually withdrawal symptoms as they are the same as why they went on ADs in the first place.

The success rate of ADs was only very slightly more than the placebo.

They said they have a place, but for mild depression GPs are not supposed to prescribe them. But GPs still are. In the past there was a financial incentive, and now GPs often reach for them as they are short of time in a consultation.
They are also being 'allowed' to prescribe them if a patient asks for them !

The main point was the side effects of addiction have been played down by the pharma company and withheld from doctors and patients.

SSRIs were being compared to the old type of ADs like prozac which were found to be extremely addictive and ruined lives.

The Chief Pharmacist of the Maudsley Hospital was one of the main speakers (Prof David Taylor) who has spent his entire career working with depression and treatment. He was pretty damning of their overuse and minimising the risk of addiction.

SSRIs were being compared to the old type of ADs like prozac which were found to be extremely addictive and ruined lives.

Not sure what this means as prozac aka fluoxetine is an SSRI like sertraline.

Obviously there are different 'generations' of drugs like the older versions of The Pill, antibiotics, etc.

The doctors on the programme (David Taylor) actually said that in medicine it's shocking to make the same mistake twice and not learn from it (ie the addiction issues with Prozac and now the newer types.)

I wonder if there is a type of misogyny going on with women's health.
Yes, women have hormonal upheavals, but you do begin to wonder if many GPs see ADs as a way to shut women up and get them out the surgery fast, without offering other treatments or getting to the root cause of their symptoms.
It's several years since GPs were told to prescribe CBT, counselling and even exercise for mild depression. yet I never see any evidence of it here, especially when this is the menopause forum and HRT is supposed to be the first line treatment.
It does come over as a 'pat on the head', 'go away and take this dear' - in some instances.

Yes but I’m just confused about the suggestion that SSRIs were compared to prozac because prozac IS an SSRI. Newer generations of antidepressants include SNRIs like venlafaxine. When people talk about old style antidepressants they usually mean things like tricyclics which predate SSRIs and are now only prescribed in quite specific cases.

Watch the programme? I'm only repeating what was said and of course I may have got it wrong, but the comparison of ADs causing addiction was discussed at length by Prof Taylor so he's the expert to listen to.

I wasn’t trying to be rude - just seeking clarification. I’ve taken a tricyclic, SSRIs and and SNRI myself so have developed more knowledge than I’d really want to have. I probably will watch the programme though the ADHD Panorama was unfortunately very misleading at best, so I won’t assume this programme will be any more reliable!

It's fine I didn't think you were being rude.

I felt it was quite balanced, overall, and it would be hard to dispute the knowledge of the Prof David Taylor https://www.kcl.ac.uk/people/david-taylor but if I've misunderstood anything I'm happy to be corrected!

@JinglingSpringbells so far from the doc it seems like the new class of drugs - SSRIs including Prozac - at the time they came out were being positively compared to benzodiazepines, which are a totally different type of drug (a sedative and not a type of antidepressant, but would have been being used for things like anxiety). Benzos had been shown to be very addictive in the traditional sense of the word.

I think as the prog goes on, they conclude that in some people, SSRIs are addictive like benzos. And the issue is that the withdrawal symptoms are the same as the reason for using them so they are told to go back on them.

They have a case study of a woman who's been trying to come off them for 5 years as well as a MH dr.