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[Sue52]

I have been on HRT for over 3 months now (Utrogestan 200mg plus gradually increasing my patch to Everol 50). The HRT has stopped the hot flushes in their tracks and the anxiety and low mood is improving very slightly (I think!).

My sleep, however, is still very poor. I have broken sleep from around 11pm to 3pm and then toss and turn until I get up at 7am.

I am seeing my GP on Tuesday. He has previously suggested that I add in a low dose antidepressant to help with the sleep. He suggested either Mertazapine or Amitriptyline.

I feel very nervous about doing this and dread any side effects but would love to improve my sleep which may help improve my low mood.

Any thoughts on this? Have you had good/bad experiences with this approach? I would appreciate your help.
Many thanks, Sue.

[CLKD]

What's to lose?  Many ladies find that as well as HRT that they require an anti-depressant and/or an anti-anxiety medication.  Because HRT does not always relieve all symptoms!  I would opt for Mertazapine in the first instance and start it at a weekend  .

The other thing that I found helped was Kwells or an anti-histamine to get a good night's sleep but they didn't help mood.

Let us know how you get on?  You can ask advice at a Pharmacist too, most have private rooms now.

[Smokey]

Hi

I am on Antidepressents since starting Hrt mine are called Nortriptyline and were prescribed as they control the nerve pain I've with my Ms.
I had originally been on them for five years and although I didn't know it at the time they do help with sleep. I then decided to gradually come off them as thought I could do without them, but after tapering off them gradually
I had awful side effects when completely stopped, diarrhoea headaches, tears, low mood and my nerve pain came back even worse and no sleep again, my heads were really horrible the back of it felt too heavy. I also kept getting horrible creepy sensations for no reason.

I went back to doctors and she gave me Mitazapine 15mg which stopped most of the withdrawal symptoms I had.  My experience is they really do make you sleep I remember how great I felt after the first full nights sleep I had. The only problem I found was trying to get up in the mornings I didn't feel groggy or anything like that but I kept falling back to sleep, unless I was to get straight out of as soon as I woke.  I would advise if you decide to try this drug I would only take half of the 15mg they can be cut in half easily enough, I got a pill cutter from Pharmacy cheaply, you can always increase it but it's unwise to reduce amount once started unless you are coming off them.  I increased my dose to 30mg for mood but I found them too tiring and am now back on Nortriptyline which do seem to suit me better, no side effects except for a bit of dry mouth. Oh no side effects from Mitazapine when starting them except once I felt like everything was brighter it was a bit sereal, but that could have been either hormonal or my ms.

Hope this helps.

Ann.x

I went to doctors and she p

[CLKD]

 

[Annie0710]

I'm on day 17 of amitriptyline for nerve pain in my back.  I take 10mg and can increase to 20mg if it doesn't control pain relief

I feel better than I have done in yonks.  Because it's helping with pain I can be more active, I'm not cured but it's allowing me to do more.  I sleep brilliantly now, I take it at 6pm to avoid grogginess in mornings.  And my mood is better and less anxiety.

[dazned]

I'm on mirtazapine which stopped all my anxiety in it's tracks,also helped my insomnia. The first week I was very dozy all the time but each day it lessened. Take it at night then off to sleep.

[Hurdity]

I was wondering if it would be worth trying an increased dose of oestrogen before trying anti-depressants as you sound reluctant? At the right dose oestrogen should help lift your mood if you have no reason for it to be low. Are you still experiencing night sweats or is there any pattern to your disturbed sleep eg during a particular phase of the HRT cycle?

Have you tried all the sleep techniques before going to bed eg re lighting and calm - no screens etc? Maybe try some of these (lots of info on the web) if you haven't already done so, before thinking about ADs if you feel you want to try other approaches first?

I do sympathise because lack of sleep/interrupted is debilitating....

Hurdity x

[Sue52]

Thank you all for your replies, I really do appreciate your thoughts on this.

I have been practising all the 'sleep hygiene' measures for months now and have cut out caffeine and most sugar. Herbal teas, antihistamines and prebiotics (as suggested by Dr Michael Mosley in his programme about sleep) have not helped either.

I no longer have night sweats And there is no particular pattern to the poor sleep.

I have only been on the increased dose of Everol 50 for the past 2 weeks (slowly increased from the 25 patch), so wasn't thinking about increasing again so soon.

Would really love to be able to sleep as I am sure this would help me feel better.

It is so difficult to try to make a decision when my brain is addled with lack of sleep!

I think I am rambling a bit now so I will stop.....!
Sue x

[CLKD]

You ramble.

Problem is we concentrate so much on getting to sleep that the brain remains wired!  The night I thought "Oh not sleeping hasn't killed me yet" I have had less problems.  Those nights that I can't sleep or when I sleep for a short while then wake for hours; I read, listen to the radio, do deep breathing exercises, make a cuppa.  The next night I drop off without problems.  Sounds trite but for me it works.  Basically, stop worrying about not sleeping ....... breath from the toes upwards by tensing the muscles, hold, then relax.  I also have a deep bubble bath prior to bedtime and don't eat too close to laying down to avoid the dreadful reflux .......... bugga 

[Roseneath]

I really do understnad Sue52. I had really bad insomnia which came out of the blue about 10 weeks ago and lasted a week. I had five nights where I didn't sleep at all and got myself in a right state. I spent all day worrying about it and bought two books on it and read them  in two days. CLDK is right. You will get some sleep eventually and this time will pass. I would really encourage you to go to your GP sooner though as there are things they can give you which can help. I took sleeping tabs to get a good few nights and then within two weeks was off them. The GP was very sympathetic and said everyone gones through bad patches at some time. I found the Apps Headspace and Calm good. They have 10 minutes Mindfullness meditations which tackle everything from Anxiety to Sleep Issues (they are both free). I remember people telling me it won't last but when you are in the middle of it it is very difficult.

[walkingthedog]

Sue52  i took mitrazapine it's fantastic for helping with sleep. However i found i piled the weight on , it is well.known for this as a side effect. Did any one else taking it find this ?

[Hurdity]

Sue52 - maybe give that dose a a couple of weeks longer to kick in as two weeks may not be long enough to feel the benefit so I agree - perhaps too soon to increase just yet.

Sorry to hear about your ongoing problems with sleep - have you tried doing more physical exercise in the day or increasing this, so that you are physical tired each day? I always find I sleep better when I've been especially active.

Hurdity x

[Sue52]

Thank you again for all of your replies!

I do fall asleep quite quickly and easily, so do not worry about not sleeping, but cannot seem to maintain the sleep for a sensible number of hours.

I work part time in a job that requires a lot of standing and walking and I do go for a brisk walk in the fresh air each day but even if I walk for miles it doesn't seem to increase the number of hours I sleep.

My Mum's friend told me that having been an excellent sleeper she lost the ability to sleep for more than 4 hours a night when she hit the menopause. She said she is still like this 25 years later!!

I live in hope that things will improve....

Sue x

[Jintyhilton]

I developed insomnia following combined synthetic HRT prescribed in January to alleviate flushing and restless legs at night. After a difficult few months and a real personal struggle on HRT(s) all delivering horrible side effects; memory loss, weight gain, hair loss, anxiety and a dangerously low mood (intermittent) I ditched them and refused to take the anti depressants that my GP and consultant tried to force upon me, simply because I knew I was not clinically depressed. I researched bio identical HRT, after reading Carol Vorderman's article. I got myself a full set of blood tests (which showed that my hormones were rock bottom) found myself a private doc and I'm now on a prescription of BHRT; Estrogel 2 pumps, Testogel a pea sized amount and Progesterone for 7 days of each month. For me it has been Life Changing - I have never felt better and still can't believe that I have finally got myself to this place - I really had started to think it wasn't possible. These hormones are like our own hormones and I have had no side effects. I sleep all night and am so full of energy...it feels a lot like a miracle to me...  don't give up hope x

[Sue52]

Thanks for sharing your story Jintyhilton, so wonderful that you have found the right life changing regime for you!

Last nights sleep was very poor I'm afraid,  I woke after only 2 hours and couldn't get back to sleep. As a result, when I saw my GP this morning, I agreed to give the Mertazapine a try. He said it is often now used for a short time (a few weeks) to try to help people regain sleep as it is safer than traditional sleeping pills.

I have been waiting very patiently for my sleep to improve whilst taking the HRT but I am struggling to function on so few hours of sleep each night.
I have bought a pill cutter (thank you Smokey, I didn't know they existed), and will take just a half dose giving me 7.5 and see how that goes.

Thank you all for holding my hand through this. Fingers crossed that I start to get some sleep and don't experience any difficult side effects.

Sue x