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[Frizzbomb]

Good morning all

I’ve been on Sertraline for a year now for  anxiety exacerbated by the pandemic  .  It has helped no end, but I’ve spoken to an advanced nurse practitioner about coming off of it because I’m not feeling as sharp and a little fuzzy on it. I’m not doing my job as well as I could.

She advised me how to come off of it (I work in a school office so I plan to come off during the summer). We spoke about menopause and she said it could be time to go on HRT.

Has anyone been in a similar situation?  I mostly read about women taking both Sertraline and HRT. I’m concerned that the HRT alone will not have the same effect, that being to have an element of control over fixating on mistakes etc.

I’d really appreciate any point of view!

[CLKD]

I would continue with the Sertraline until the HRT kicks in.

MayB keep a mood/food/symptom diary to chart progress.  HRT can be Trial and Error as well as taking a while to find something which suits.  Perhaps decide which symptom you would like to ease first?

I feel dozy due to busy, involved, long dreams - it takes while to 'come round' every morning, I've taken an anti-depressant since the 1980s. I have an as necessary anti-anxiety tablet to hand which I haven't required for 2 years partly due to lock down ;-)

[scrubdub]

Hi - I started on sertraline Dec 2018  then went on HRT(mirena &gel) June 2019 and was on them both for a year before I decided to wean my self off the sertraline. I spoke with the clinical pharmacist at my GPs and we had a protocol where I would drop down my dose gradually. I was on 100mg so dropped to 75 then after a few weeks if  and when I was ready drop to 50mg. Obviously Covid happened and my gp thought it was best to stay on 50 mg to help with anxiety but it be honest being in lockdown was the ideal time ! I eventually got to 25mg then stopped after taking every other day.
I still have odd episodes of anxiety but I can manage those a lot better than 2 years ago. I can say that sertraline did help but It did leave me feeling a bit flat for 2-3 weeks after I'd stopped altogether.
The only advice is do it slow and steady then you don't get the withdrawal side effects.

[Hurdity]

Hi Frizzbomb

 

What's happening in terms of your periods/cycle? This would determine where you are in menopuase,  whether or not HRT is appropriate. Were you getting menopausal symptoms before starting the sertraline?

Hurdity x

[Shannonplussed]

I tried stopping sertaline once I was on HRT. The first time was an outright failure. I was a wreck. I restarted and things were good. Once I had more time on Hrt and that end of things seemed good, I felt overserved by sertraline. I tapered down and went off it again for several months. I just wasn’t myself. I don’t know if my brain chemistry has changed altogether since starting or what (if it even matters), but I’m just not myself off sertraline. I restarted but now only take 50mg, whereas I’d been on 75mg for about 5 years. The slightly lower dose feels better, as does less estrogen...when either of those things are too high for me, I feel edgy/irritable/angry/wired/generally unpleasant.

[Frizzbomb]

Thank you so much everyone. I’m definitely thinking twice about coming off Sertraline before going on to HRT. This whole business sounds so daunting. I’m not looking forward to a trial and error period of time.

Hi Hurdity!  It’s really difficult to say if I’ve been experiencing menopausal symptoms prior to this - it was suggested to me around 3 years but this was while I was talking to a counsellor about dealing with worries over my teenage daughter.  But then I’ve always been a worrier to the point where I’ve had talking therapy but I didn’t feel this would work for me hence taking Sertraline (50mg).

I’m 52 and haven’t had a period now for just over 60 days. 

I’m so grateful for your responses - they are helping me take a more measured approach.  If I think about what’s worse - fuzziness or crippling worry then I guess being messing up cos I’m fuzzy but not caring so much is only slightly better!

[Gilla999]

Just to add - you absolutely need to reduce the Sertraline gradually. Everyone is different and you won't know until you try but many people find they can only reduce by 10% a month without getting (temporary) withdrawal effects. This generally only lasts for a couple of weeks depending on how much you've dropped and how quickly, but it's not pleasant and worth avoiding! However Sertraline is tricky because it only comes in a tablet form so doing 10% can be tricky - I ended up buying a pill cutting machine thingy!

My advice as others have said would be to settle on the HRT first and then think about tapering off the Sertraline. In my experience doing too much at once always makes things worse, if only because it's impossible to track what has caused what reaction or side effect.

HRT can indeed take a while to get right, but it can also work very quickly - for example when I started Lenzetto it worked on my symptoms pretty much immediately, and it's just the Utrogestan part that I'm still toying with to try and get right, but that's a minor inconvenience compared to what I was going through.

Good luck xx

[Frizzbomb]

Thank you Gilla. The ANP I spoke to made it sound so straightforward but I will take it much more slowly!