Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Joyce on July 06, 2015, 11:48:30 AM
-
Due to see GP on Wednesday regarding whether I will be allowed to continue with Citalopram for anxiety. For the past 2 months I have tried to reduce my Estradot to half a 25mg patch per week, as per GPs instructions. However, hot flushes coming back. Not lots, but about half a dozen per day. She suggested last time they could increase the Citalopram to help. What I want to know is should I fight to keep my HRT, but half a patch 2 x per week or go with the increased Citalopram? I've got enough patches to fall back on for now, but really don't know what to do. Hate the feeling when it comes over me. Gets sweats with some of them too.
-
How long have you been on HRT? And why are you trying to come off it? If you don't mind my asking?
-
What do you feel happier with ? Lots of ladies have both and do well so which ever you feel best suits you stick to it and tell the Dr what you want ! After the NICE report comes out,if it's anything like the draught,I think Dr s will get a shock ! Well mine will when I print it out and show them ! If you do well with a certain regime don't let them sway you to change. Good luck for Wednesday's appointment.
-
Been on it for best part of 20 years or so. Hysterectomy in mid 30s. Conscious of fact that many doctors say 60 is the limit. I want life quality first & foremost. I've read about continuing on HRT beyond 60, although some GPs still haven't read the research! I'm 60 next year. If I thought the Citalopram would be all I need, I'd happily come off HRT. Not on loads of meds in total. 10mg ramipril for BP, inhalers for asthma, HRT & 10mg Citalopram. Would rather not need anything, but needs must.
-
Stick with what works for as long as it works? Sometimes my GP thinly hints that it's time to try without my ADs :o …… I think he's box ticking ;)
Dazned: another thread about the NICE Report perhaps? It's news to me :-\
-
If you want to stay on it, stay on it then, like you say, quality of life. I had an early menopause, wasn't diagnosed. Had really bad everything, especially vaginal dryness, so painful. I've just had enough. If you've found a regime that works for you, keep going with it. My mum took HRT until she was 70 and stopped because we thought it was dangerous. Now the research has reversed all that. Since stopping the HRT, mum has lost 3 inches has back, knee and hip problems and has really aged. I wish I had never nagged her to stop taking it! :'(
-
You could come off the patches and try the ADs with the proviso from your GP that if it doesn't work they will let you go back on the patches.
Bit of a compromise but as you are taking such a minute amount of HRT then perhaps worth a go.
Difficult one CG, what does you gut say.
Honeybun
X
-
My gut actually days stick with the HRT. I wanted to see my registered GP who is the most sympathetic of them all. He is always difficult to get hold of. On sick leave & then on holiday until mid August. So will see what this GP says on Wednesday.
-
By which time you have made your decision to ……….. if you are getting benefit from the regime, then stick with it?
-
But I'm not CLKD. Only on half a 25mg patch once a week instead of twice. I got the feeling GP would prefer me to be on Citalopram instead. I'm happy to do that, but wondered if Citalopram aline would be effective for flushes if I come off HRT. Then there's going through the side effects again if I up the Citalopram. Oh heck wish this was all done & dusted by now.
-
If I up my AD which is in the same family the only difference I am aware of is a lift in depression. The original start up side effects are long gone, fortunately or I couldn't have tolerated this drug.
-
OK thanks for that CLKD. Will have a think & see what she says on Wednesday.
-
Can't give any advice as I've never had HRT just 10mg of citalopram for just over 12 months now. Not completely stopped the flushes but they are less frequent and severe. I am always wondering what would happen if I tapered off the AD. Are the flushes gradually stopping as time post menopause increases or is the citalopram controlling them?. Just can't bring myself to see what would happen and the thought of stopping and maybe having to restart the AD is not good. Hope the appt goes well and will be interested to see how you get on.
Thorntrees
-
Hi There
I take 40mgs of Citralopam and also 10mgs of Oestrogen daily. I also have a mirena coil
All okey dokey and fine on that mix. I have few hot flushes now and appear to be ok.
Hugs Mrs J xxxx
-
I am always wondering what would happen if I tapered off the AD. Are the flushes gradually stopping as time post menopause increases or is the citalopram controlling them?. Just can't bring myself to see what would happen and the thought of stopping and maybe having to restart the AD is not good.
That's what I'm scared of.
-
20mg of Citalopram = no sweats for me. 10mg and they are reduced.
The only thing I would say is that I've been on them for years and can't get off them now.
-
Hi cubagirl
Well I think you know what my advice will be! In your position I would never have tapered off the HRT and then have to take an AD to combat the return of symptoms. If you think there are risks with HRT, then there are also risks with ADs and at least the HRT you are using is bio-identical and you don't have to take a progestogen! No contest in my book.
Dr Currie (on this site) says that the risks are equal to the benefits between the ages of 60 and 70 (which is why at 62 I am still taking it, as are several of us on here). There is nothing that says you should stop at 60 apart from out-dated doctor's opinions, and as dazned says, the new NICE guidelines will be telling doctors not to prescribe ADs in preference to HRT for the relief of menopausal symptoms. You are on a tiny amount. I would increase it to an amount that you are comfortable with - and personally I would want to taper off the ADs and stick to the HRT - 25 mcg twice a week is still a low amount. I am tkaing 50 mcg twice a week as are several other over 60's. The ADs will not give you back oestrogen and you could still experience health problems - as Debe said - such as osteoporosis.
If you do not have any of the risk factors, and you keep your weight within a healthy BMI ( lose weight if you need to), take regular exercise, eat a healthy diet, don't smoke and limit alcohol, then go with your gut feeling and don't let your doc persuade you otherwise. I am sure if you consulted Dr Currie she would also say the same :)
Hurdity x
-
I'm sure CG will be along to answer for herself but as I remember she started ADs for anxiety and not for meno symptoms. Some need both as HRT does not always help with anxiety.
It has never done anything for my anxiety at all and if ADs had suited me and helped I would have taken both.
I agree that ADs should not be prescribed for meno symptoms but expecting HRT to cure anxiety is not realistic either.
I really wish it did though :-\
Honeybun
X
-
Mrs Mopp - weaning off anti-depressant medication isn't a big problem, done under supervision with a tapering dose: GPs have access to half dose-sized tablets - it took me 9 weeks and once I realised that the side effects lifted after 48 hours, I was OK. Now on another AD which kind of suits.
-
Believe me CLKD I have tried many times over the years. I just end up anxious and depressed. I guess that's why I'm on them :o
-
I'm on the Citalopram for anxiety. Doctor suggested I reduce the HRT to see how it went. She suggested that Citalopram could eventually be used instead of the HRT. I was doing fine for a few weeks, but now flushes are returning unfortunately. I've been reducing HRT for quite some time. It's certainly not as bad as when I went cold turkey when I first joined this forum, but I am finding them increasingly uncomfortable.
I do have some risk factors, but I have always said life quality was more important. Think I've made my mind up now, but will see what's what on Wednesday.
-
I never found hrt helped me with anxiety,that's why I have low dose AD alongside my hrt. You do what feels right for you,one,other or both. Let us know how it goes,good luck.
-
CLKD I tried to get off AD's after 14 years, given them for post natal depression initially and then forgotten. I weaned off over 9 months, but dropped the last 25mg overnight on the say so of a pharmacist. Bad idea, anxiety and shaking came straight back. Then given a hign dose of beta blockers nearly killed me, more anxiety and panic. I lasted 6 months without and would have gladly died so had to go back on. My dream would be to try again to get off or at least reduce after all this meno lark, but the docs and my family are against it.
-
Sarah may I ask why you would like to come off them? I to felt so bad earlier this year I too didn't want to be around :-\
Now I've started on low dose alongside my hrt and this has allowed me to function again if that's what makes one feel human again I will happily take them indefinitely . ;)
-
Just back from GP. To take HRT half patch twice per week, plus continue with Citalopram, until after my holiday. After that drop HRT & continue on increased dose of Citalopram. She said I can continue on HRT beyond 60, but I'm just delaying the inevitable. I could continue to 65 or 70 if I want but will still end up with flushes/sweats then. She thinks that because I'm already on BP tablets, the sooner I come off HRT the better. Guess I may have to just put up with the discomfort of coming off HRT.
-
Just back from GP. To take HRT half patch twice per week, plus continue with Citalopram, until after my holiday. After that drop HRT & continue on increased dose of Citalopram. She said I can continue on HRT beyond 60, but I'm just delaying the inevitable. I could continue to 65 or 70 if I want but will still end up with flushes/sweats then. She thinks that because I'm already on BP tablets, the sooner I come off HRT the better. Guess I may have to just put up with the discomfort of coming off HRT.
Did you mention the NICE guidelines to her? Because it does sound like she's not read them?
-
Hope this works for you CG and good idea to wait until after your holiday.
I don't think doctors will ever change their opinions over very long term use of HRT, ie...60 and well beyond.
Even Hurdity who is on a sequential regime said in a recent post...I think...that she would do this up until 70.
I cannot imagine bleeding for so long, but that's a personal thing.
I think it's so much easier if you do not have to use progesterone but for most of us this is the case.
I know my GP will want me to at least take a break to see how things go which I am prepared to do that's why I have cut down as far as I can...to accustom my body to smaller and smaller amounts of hormones.
It's such a difficult one as there are so many advantages of just ticking over with the minimum amount to keep symptoms at bay.
Honeybun
X
-
Why would symptoms continue into late 60s/70s? how is it 'delaying the inevitable': or am I fortunate thus far :-\ - doesn't the body know when to stop! I suppose that by having a break one finds out what one's hormones might be up to!
My periods stopped eventually. Occaionsal meno symptoms, nuisance value only …….. currently OK …..
Maybe a separate thread for NICE Guidelines?
Sarai: I have to take ADs for Life otherwise :-X
Enjoy your holiday CG :)
-
I said about life quality, which she agreed with. No matter how often I speak about HRT, same answer. 60! Even meno consultant said 60.
-
Maybe next time you speak with GP/Consultant they will be more up to date?
I agree - quality of Life is important ……..
-
I'd have thought that I'm on such a low dose anyway, they would have been OK with it. Appears not. There are as many guidelines which say you can continue as those who say stop. I've read various ones.
-
It all seems really odd as years ago when HRT Was first invented so to speak women were on it for 20 years or so. Even those who went on it at Meno rather than those like yourself you went on due to having a hyster, so presumably it wasn't unusual to be in it from 50 to 70.
It's almost like there are fashions and trends in these medicines where the medical profession is concerned, I guess thinking changes over the years.
I'd love to ve to see some stats on what difference it has made to life expectancy or certain illnesses, these shifts in thinking, but there won't be any as I guess in the sixties and seventies Etc they weren't studying the effects of HRT, they thought but was the new miracle drug.
Also for yourself you don't have the added complication of needing progesterone like so many long termers need which I though was the breast cancer risk, or have I got that the wrong way round?
Plius you gave a very low dose of oestrogen.
Anyway glad they have sorted you in the short term.
So many factors come into things as well, people's own underlying physiology, other meds they take, lifestyle etc I guess that's why it is so complex
-
I questioned the idea of increasing Citalopram, as in, which is the safest to continue with? They prefer the Citalopram. Bet it's the cheapest option! Will see how things go & think I may see different GP next time.
-
I questioned the idea of increasing Citalopram, as in, which is the safest to continue with? They prefer the Citalopram. Bet it's the cheapest option! Will see how things go & think I may see different GP next time.
Another option might be to email Dr Currie to get some advice - I think the fee is 25 pounds but it would be worth it if you got some useful advice that you could then print out and take to your next Dr's appointment. Just a thought?
-
Hi cubagirl
Well I think you know what my advice will be! In your position I would never have tapered off the HRT and then have to take an AD to combat the return of symptoms. If you think there are risks with HRT, then there are also risks with ADs and at least the HRT you are using is bio-identical and you don't have to take a progestogen! No contest in my book.
Dr Currie (on this site) says that the risks are equal to the benefits between the ages of 60 and 70 (which is why at 62 I am still taking it, as are several of us on here). There is nothing that says you should stop at 60 apart from out-dated doctor's opinions, and as dazned says, the new NICE guidelines will be telling doctors not to prescribe ADs in preference to HRT for the relief of menopausal symptoms. You are on a tiny amount. I would increase it to an amount that you are comfortable with - and personally I would want to taper off the ADs and stick to the HRT - 25 mcg twice a week is still a low amount. I am tkaing 50 mcg twice a week as are several other over 60's. The ADs will not give you back oestrogen and you could still experience health problems - as Debe said - such as osteoporosis.
If you do not have any of the risk factors, and you keep your weight within a healthy BMI ( lose weight if you need to), take regular exercise, eat a healthy diet, don't smoke and limit alcohol, then go with your gut feeling and don't let your doc persuade you otherwise. I am sure if you consulted Dr Currie she would also say the same :)
Hurdity x
I was going to post but pretty much feel the same as Hurdity on this. I'm using Estrogel and Utrogestan and will take them as long as I need, I'm really not hung up on a year of expiry of me being able to use HRT, and certainly wouldn't swap one drug for another with an even more suspect record.
Statistics take into account all manner of factors, including for example the lung cancer smokers who continue smoking, the alcoholics that continue drinking. If you however make sure you're doing as much as possible 'right' , then you're keeping your body in its optimum condition and reduce risks. Taking bio identical hormones is likely to be kinder too (according to the research studies).
GG x
-
Why change your GP :-\ ……….. as Citalopram is an AD it's not really comparable, regardless of the cost to the Practice ::)
-
This is just my personal opinion but I would say definitely take HRT for as long as you need it. The time limit was just plucked out of the air with no firm basis and was on the back of a very flawed scientific study. That study has probably caused more damage than anyone will every know and thousands of women have been denied life changing HRT treatment because of it - I have heard it referred to as "the lost generation". I wonder how many women have lost years of their lives and will end up with hip fractures and curvature of the spine because of it?
The million women study (or whatever it was called) has now been well and truly discredited and it would appear that opinion is now swaying in favour of HRT. If someone is happy taking it at 60 or 70, why should they stop?
-
Agreed Mary G! quality, quality, quality ………
-
I'm continuing to do all my research before next visit, but will see GP who put me back on HRT a while back. He's the only one who seems to keep abreast of current findings, or he was last time I saw him. He's just very hard to get an appointment with.
-
Let us know how you get on!