Starting antidepressants now while considering HRT for possible perimenopause

[BWJA921]

In consultation with my doctor, I have recently been prescribed antidepressants for low mood and anxiety resulting from a variety of life factors (upcoming house sale and spousal bereavement).

But I also have other symptoms for the last year or so like achy body, lack of motivation, brain fog, increased weight. I havent spoken to my doctor about these perimenopausal symptoms (as they have been a back ground white noise in my life). I can only make appointment for 14 August.

I am desperate for the low mood to start lifting so don't know whether to start taking the antidepressants now and potentially combine this with HRT then begin to taper off the antidepressants.

Any gentle advice gratefully received. 😊

Personally I would try HRT ahead of anti depressants because the aching and brain fog sound like symptoms of low oestrogen and you may find your mood lifts when you feel physically better.

I'm very sorry for your loss OP x

Sorry for your bereavement

Agree the HRT could help all of those symptoms without any of the side effects of starting or stopping ADs. Personally I’d wait before starting ADs as it’s only a couple of weeks.

Also have your thyroid function checked as that could also account for many of those issues.

I'd also try hrt first. I was in a right state before starting. I'm 42 and was so anxious and just so low. I feel a lot better on it although it's taken 6 months to get the rhythm of it right for me

I found hrt worked faster on anxiety and low mood than anti depressants.

NICE guidance since 2015 is that ADs are not first line treatment for peri/ menopause and HRT is first line treatment.

I'm sorry for your loss. Give HRT 3 months then have a review and if necessary increase the estrogen or change the type of progesterone.

Please don't try combining ADs and HRT as this makes it very hard to get the right dose of estrogen (because you don't know which drug is helping or not.)

ADs also have side effects like weight gain, dry mouth, constipation which is another reason to hold off them.

Slightly differently, if you need to talk to someone, a counsellor may helpful with the bereavement issues.

Thank you for all your advice. I am going to try HRT first and review.

I'm getting grief counselling currently aswell which I am finding really helpful.