Anxiety meds

[Flowerbfbfbf]

Terrible anxiety including panic attacks, after some severe health trauma (hospitalized with illness, long term implications).

Anxiety is worse on low estrogen days and I have not yet got HRT. I do not want to keep putting up with the anxiety, panic attacks and now a fear of the panic attacks. I have a prescription for Sertraline, but only tried it for a week as I felt so rough on it. Any advice appreciated on whether to try again with the sertraline or ask for Xanax, to take to try to break the bad anxiety days/panic attacks.

Thank you.

You could ask to try citalopram. It’s been like a wonder drug for me x

Thank you @User0000009 Please can I ask if you take it every day or for the last two weeks of the cycle?

I’m post menopausal but had anxiety issues. It’s an antidepressant that I take every day x

I take escitalopram. Worked wonders for me

Thank you @QueenBitch666 I think I have to try Sertraline again. It didn’t seem to have an effect, but I only tried it for a week.

You tube, Joanna Moncreif

Also Dr Chris Palmer

Anti depressants take about 6 weeks before they start working.

I take Trazadone - absolutely brilliant. It keeps the anxiety down and helps me get to sleep without feeling groggy in the morning.

With SSRIs you normally feel worse for a couple of weeks and then started to gradually feel better. Took me about 3 months until the anxiety felt like it was in the distance.

Thank you so much, will watch the Youtube channels and strongly considering trying sertraline again. Had panic attacks for two days running, they seem to be getting worse and evading my normal tricks to calm them down.

Got a prescription for Xanax. Is this worth trying on days anxiety is bad, as a faster alternative? No problem with addictions and can stop easily e.g. opioid-based pain meds.

Feeling very miserable and scared by this.

Forgive me if I've missed any of your other threads @Flowerbfbfbf but - genuine query- why are you being offered anxiety meds rather than HRT?

this goes against NICE guidance of 2015.

There is a lot on the website of Dr Newson about how for many women, these other meds don't work.

Is there a medical reason you aren't being given HRT now?

@Flowerbfbfbf I found your other posts.

What sounds ideal for you is long cycle HRT. This is in the NICE guidance as an option for women who are intolerant to progesterone.

It's estrogen-only for 3 months, and a course (14 days) of progesterone for only 2 weeks in those 3 months.

So it's 10 weeks on estrogen then 2 weeks on both hormones.
You could also try using Utrogestan vaginally to reduce the side effects.

I'd really advise you not to start ADs or similar at the same time as HRT. You need to get the optimal dose of estrogen first and using other meds at the same time makes it very hard to know what's working. ADs etc can take weeks to kick in and they also have side effects.

You don't say if you have a problem seeing your GP but if you can access yours, go along and ask for gel and Utrogestan and to use the 3-monthly cycle.

Thank you so much @JinglingSpringbells I appreciate this so, so much.

No reason not to have HRT. Am late 40s, with miserable symptoms. The gynaecologist (not in the UK) refused to prescribe HRT as I have not yet missed a period. I called back to request it as they say it is not given to anyone at this stage because of an increase in the risk of breast cancer.

The GP prescribed Xanax (haven't taken it, but nice to know it is there) or I can try sertraline (am very hesitant about the latter). I do not have anxiety after a traumatic few years. I was hoping the HRT would remove a factor that was worsening it.

I will try a private gynaecologist, to see if there are options to get it.

The gynaecologist (not in the UK) refused to prescribe HRT as I have not yet missed a period. I called back to request it as they say it is not given to anyone at this stage because of an increase in the risk of breast cancer.

@Flowerbfbfbf I am really sorry you are having to put up with this dreadful non-treatment.

Which country is this?

In the UK, HRT is prescribed when there are symptoms. There is no higher risk of BC if starting sooner because all HRT is doing is topping up your own hormones with a body identical product.

https://www.menopausematters.co.uk/risks.php

If HRT is commenced at a young age because of premature menopause, then the use of HRT up to the age of 50 does not increase breast cancer risk any more than in women who continue to have periods up to the age of 50. Additional risk from HRT only applies if it is then taken for more than 5 years after 50.

^^ This is written by Dr Currie, NHS gynaecologist, awarded the MBE recently for her work with menopause.

@Flowerbfbfbf definitely take the Xanax when you are feeling really bad, it's amazing stuff for anxiety and nice not to have to take something daily

@JinglingSpringbells Thank you so much for following up. Germany. Seeking a private appointment and will update if they have different advice.

It is ridiculous, there are risks for everything and they are happy to give an SSRI that does have some specific risks for me or Xanax.

Thanks @Devilsmommy It is a big relief to have it to hand. I seem to have bad anxiety for a stretch of two or three days and then a few individual days during the final two weeks, so not taking something all the time is good.

I worked out I really have problems on day 16-18 and days 26-2 (this ranges a bit, as cycles not regular anymore - this is what it would be on a 28 day cycle). Is there any option to just have oestrogen gel on these days?

You can of course have private appts with many consultants in the UK, by video now. Most did it during lockdown and are now still doing this for patients who can't get to see them.

(I don't know how prescribing would work but you could at least have a consultation.)

Did I mention upthread that you have the option of a 3-monthly cycle?
That's every day except 14 days, out of 84 days, with estrogen only.

Thank you @JinglingSpringbells Waiting for a private appointment and will ask about the option of a three month cycle. Will update with any outcome.

Ridiculous antidepressants are offered so freely, but not hrt.

What dose sertraline did they start you on?
I am on both sertraline and HRT. My panic and anxiety went through the roof this year.

@TreeHuggerMum1 it was 25mg. I did not like the side effects, so did not want to be on it full time for the days when anxiety is a major issue.

I felt on top of it this last week. Took half a Xanax when it started a few days ago and again when it came back. But was mainly at home. Just knowing I have something that can stop it helps.

If you do decide to give sertraline a go, get a pill cutter and start smaller. Half it, or even quarter it, until you get used to it. Im dosing up at the moment after six weeks on 25. I am taking one and a quarter so I don’t get nasty side effects.