Anti-depressants in Menopause

[Sulusu]

I'm 50, on HRT patches (which have helped lots of physical symptoms) but my mood is lately very very low. I will be making an appointment to see my GP about it. This sudden low mood feels like it's come out of nowhere which is why I'm wondering if its menopause related. Can anyone tell me which anti-depressants have helped them in menopause?

I have tried things like Sertraline in the past but never got on with them at all.

I have got lots going on in life and have had some bad news, but this feels different than other hard times. I feel like I'm drowning in heavy water.

I'm on Fluoxetine which, after a really rough 'bedding in' period of a month, has been excellent. I was sufferering from extreme anxiety which prevented me from working temporarily.
I nearly gave up with the Fluoxetine however, as it initially worsened my symptoms.

Also, look at Dr Tracey Marks on YouTube. She is an excellent resource and her videos are concise and non-waffly.

Following with interest as I am in the same boat. Before I started HRT I twice went to the GP with anxiety and depression symptoms and was prescribed antidepressants - first fluoxetine (prozac) and then another one - citalopram I think. The side effects from both were brutal, and neither helped with my mood as it was hormonal related.

HRT has helped but I am currently having a blip and not sure where to go from here - more HRT, add in an antidepressant, or just power through and hope as the hormones stabilise, so does the mood.

Yes thats similar to me. HRT has helped me with lots, but it also gives me ironically a bit of anxiety and painful boobs. I'm not sure upping it would make those symptoms unbearable. Which why I'm thinking a combination of HRT and Anti-depressents might be better.

I was offered antidepressants, when I pitched up at the doctors saying i could hardly sleep ie waking up at 3 am regularly etc, it's not depression it's hormone imbalance, lack of testosterone etc, had to go private for HRT and the testosterone initially, then the Dr picked up the prescription later, I was not depressed just bloody tired and overweight, due to the carb snacking at 3am which tiredness drives you to do.
I was depressed at 31 years of age having just lost my father and having two kids under 2,( knackerd) then Prozac worked wonders
Over the last two years I have sorted out my gut health and everything is so much better

Sertraline caused me awful night sweats so I stopped them even though HRT initially stopped night sweats. But it did help with my mood.

Any other antidepressants that don't increase night sweats ?

Paroxetine. Started it before HRT. Has been a real help.

I was very reluctant, but it is available in liquid drops form. So I could just pace myself up from a single drop to a point where I wasn’t scared of the tablets. I’m fine when on medication. But eye up side effects suspiciously when being offered a new one. So it was a nice easy on ramp for me.

I've been on HRT for 10 months and started Prozac 1 month ago (doctors don't think my depression/anxiety is menopause related - unfortunately it seems to be down to yet another long Covid relapse - I've had long Covid for 2 years). The Prozac made a difference to my mood within 2 days (which was a huge surprise) and I've had minimal side effects so I'm really happy with it so far.

I had a GP appointment today. To my great mortification I blubbed a little when talking about why I was feeling down. GP has put me on a low dose of Duloxetine to see how I get on with it. He also gave me something for the physical symptoms of anxiety temporarily.

I have a check up appointment for 2 weeks time.

Fingers crossed it helps as this morning I think I got close to a full on panic attack, which is not like me at all. He didn't think it was a good idea to change my HRT at this point, but to see how I get on with the medication first.

@Sulusu glad you got something and hope it helps.
I’ve been on HRT for two years and find it brilliant but developed awful anxiety out of nowhere earlier this year.
Citalopram (after a few weeks of side affects -very sleepy and a bit nauseous) has worked wonders, I feel so much better, Im back to “me” again and really enjoying life.

Another vote for Paroxitine here… took a few weeks tweaking the dose, but have been settled on it for a while now. I was very apprehensive about taking ADs but you’d have to prize them out of my cold dead hands now!
They have “evened” me out, calmed my erratic moods, stopped the daily crying etc. Works for me!

I have always suffered with anxiety and as a result been on Citalopram for many years and has been controlled. Part of my perimenopause symptoms my anxiety increased. Been on HRT now for a month and feel great. So would say citlopram is great for low mood and anxiety. When you start it or any antidepressant. It can make you feel worker before better and takes about 6 weeks to work and can have quite strong side affects which settle down after a few weeks. Defo work sticking with though. Good luck x

@Sulusu Coming to this a bit late after your appt, but it's a little surprising your GP has given you ADs

The recommended way forward - from specialists and NICE- is to first increase your estrogen dose. ADs do not work for hormonal depression (loads and loads on this on the website of Dr Louise Newson.) NICE guidance is low mood responds to estrogen and the right dose needs to be used. The guidance changed 8 years ago and GPs are told very strongly not to prescribe ADs for depression/ low mood unless it existed before menopause.

ADs may only add some side effects which you don't want.

Depending what dose of estrogen you are on and how long, it's very possible you need a higher dose, especially as you get further towards post meno.

It's also possible that whatever progestogen you are using is not suiting you.

Are you using a combined continuous sort or sequential?

@Sulusu If you feel able to, would you consider discussing with your GP when you see them again in 2 weeks. Refer to the NICE guidance. The next step should always be increase the estrogen dose- and give that 3 months- and / or consider a different progesterone.

If you are using Utrogestan or Norethisterone many women give it up /swap it because of low mood.

@JinglingSpringbells I'm on Evorel Sequie 50. I still have periods although not really regular anymore. I have had some anxiety before all this, but never this bad before. I have vestibular and ocular migraines so my choices with HRT are a bit limited. I will ask the GP again in 2 weeks if maybe my oestrogen should be upped a bit, but I'm worried it will make my already very sore boobs much worse.

I'm three days into Duloxetine today and I am feeling a wee bit better mood wise. I think it's hurting my stomach though 😑 I'm hoping that settles.