Your symptoms sound a lot like mine. I was on sertraline, and happy on it for years, but last fall it all just felt like too much. I was too keyed up and irritable. Like how the first day or two on sertraline the anxiety felt SUPER magnified before it felt better after settling in a few weeks.
I decided to try to taper down my sertraline. My thinking was that if my symptoms were caused by low estrogen, and sertraline increases serotonin and so does estrogen, perhaps I was being overserved. I am not on any sertraline now and there is still some background anxiety. What my tracking has showed me though is that with higher estrogen doses, my irritability, anxiety and on edge feeling increases. I think perhaps that what I thought was low estrogen anxiety was actual HIGH estrogen. That due to increased FSH of peri/menopause, my body was pumping out more estrogen than I thought it was. So piling on more estrogen, and adding sertraline, I was flooding myself. Verging on serotonin syndrome. This is my current working theory.
I recently halved my dosage of estrogen as I wasn’t seeing a benefit, and am considering further reduction. I have had tests to see where I’m at. I have a Mirena which acts locally not systemically (someone will be along to say that it does act systemically, but primarily it acts locally). So the estrogen in my system as a whole wasn’t complimented with progesterone appropriately, so the overall balance was off. I *think* I’m on the right track now. It’s hard to know but I’ve got two years of symptoms, tracking, and trial and error to see what’s worked and whatnot.
