Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Sallyyy on April 29, 2023, 07:44:57 PM
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I hope it’s ok to start a second thread in a few days.
I just wondered if anyone is taking antidepressants and finding helpful for severe anxiety plus depression.
I know the NICE guidelines say not to prescribe ADs for menopause but this is something I have had previously.
I’m 2 years past last period and had been very well on a v low dose AD for at least 10 years but have had an awful relapse.
Not sure if dose of AD was just too low to fight it off. Nothing happened. Was feeling fine and then came out of the blue.
Dr thinks not good idea to introduce HRT at the moment when everything so difficult and I agree but I may need to change AD if things don’t improve.
I’m not able to work at the moment and virtually housebound. Completely the opposite of my usual self. Very scared that I won’t get well again.
Would love to hear from anyone else who has overcome the same. I think one my fears at the moment is that ADs don’t work when oestrogen low in post menopause x
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Have you upped the dose of your regular anti-depressant? When my brain feels low for more than 3 mornings I add 5mg to my regime: I take 10mg at night and usually 5mg each morning, the extra 5mg really helps within 3-5 mornings. My GP is OK with this.
It may be that hormonal fluctuations are causing the alteration, however: trying an extra dose of AD first, then adding HRT if you require it.
Why would you need HRT unless U are experiencing other symptoms? One shouldn't immediately blame menopause for everything ::) although we do.
I was housebound for several months in the 1990s with anxiety: thought that I would never leave the house or go into our garden - gradually with ADs I recovered enough to improve my activities and these days am generally OK. Especially when doing things spontaneously ::)
Try not to worry too much about leaving the house. If you need to sleep, do so. Sleep heals. If you can listen to the radio, watch TV - though I could never follow a story line at that time - read .......... let us know how you get on.
This too will pass :hug:
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Please feel free to start as many threads as you wish too. :)
I would never manage without an AD. What I have found is, it can take a while to find one that suits. For me it helps to take the edge of my depression but does not get rid of it.
You will not always feel this way. You have had so much to deal with and it is bound to have had an effect on your mental health. I do not think there is any harm in trying an AD. Which one are you currently using and which dose? If the current one can be increased then that would be something to try.
I know when starting a new one you will need to taper off the current one first and that can be difficult but perhaps the DR can give you something to help ease the transition.
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Thank you replying. I was on a very low dose of clomipramine (18mg - standard dose is 50-100mg.)
It’s an old fashioned tricyclic.
I have slowly increased the dose back up to 50mg. Been on that dose for 12 days but no improvement yet.
It’s interesting that you say not everything down to menopause. Everywhere I look says to take HRT to sort it out but I have had different episodes of anxiety / depression.
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Thank you replying. I was on a very low dose of clomipramine (18mg - standard dose is 50-100mg.)
It’s an old fashioned tricyclic.
I have slowly increased the dose back up to 50mg. Been on that dose for 12 days but no improvement yet.
It’s interesting that you say not everything down to menopause. Everywhere I look says to take HRT to sort it out but I have had different episodes of anxiety / depression.
I think they say you should feel an improvement for four weeks with antidepressants. Hopefully you will feel a change now that you have increased your dose.
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Who oversees your ADs etc.?
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My GP oversees the ADs. She is very nice but I think I may need to consider paying to see a psychiatrist. The NHS wait locally is very long.
Thank you for sending the kind messages. I can’t imagine feeling well again.
(I have increased the dose a couple of weeks ago @CLKD.)
Does anyone else take anti depressants ?
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Hi Sally
I will tell you my story… was on SSRI (Prozac) for years after birth of my first son…(he’s nearly 17 now). Felt well so decided to taper off really slowly. Like over a year. Sadly that was about the time that both the pandemic and peri hit. Plus in hindsight I think I cannot manage without an AD, I was kidding myself. I thought I would be “proving” something if I could get off it.
Anyway I was down to a super low dose and started to get bad cyclical moods and bad anxiety again.
Went back on the Prozac at my old dose. Nothing happened! Aaargh. Increased the dose. Still nothing happened.
At the time I was starting HRT due to hot flushes and was on a medium dose.
I decided to try an SNRI (venlafaxine) to try to improve mood and also address hot flushes at the same time (the HRT dose I was on helped but I was still struggling with them). Venlafaxine is also a first line treatment for hot flushes for those unable to use HRT. I was unhappy about starting a new AD (especially as SNRIs are difficult to stop) but didn’t have much other choice.
After a couple of weeks, massive improvement in mood on the lowest dose of venlafaxine. That was about 18 months ago now. Much more stable both mentally and hormone wise. I am still peri so not exactly the same situation as you I know. I also had CBT just before I decided to start the venlafaxine which helped enormously with the anxiety.
Can I ask - do you have any other menopausal symptoms? Hot flushes etc? Your mood change could well be to do with declining hormones but not definitely. Have you ever tried any other types of AD? It is possible for ADs to stop working as they should. Prozac is particularly well known for it. Has your GP discussed changing ?
Hoping you feel better soon. It’s the absolute pits I know.
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Morning. I don't understand why people think that ADs are difficult to stop :-\. Many years ago I weaned off 1 type in order to start another: it took 9 weeks of tapering. Bounce back symptoms at each lower dose remained for 48 hours. Once I realised that I didn't get worse as I tapered ......
Some ADs can be stopped over night.
I found over the years [since 1988] that if I tried the same AD it wouldn't work, probably because the brain was used to the 'recipe'. Fortunately most of the medication kept my brain in order for 6+ years B4 poooping out ::). I have taken 10mg of escitalopram at night and 5mg in the morning for about 12 years now.
Prozac sent me :cuss: :argue: ::)
Sallyyy - what dose AD are you taking?
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Hi Sally
I will tell you my story… was on SSRI (Prozac) for years after birth of my first son…(he’s nearly 17 now). Felt well so decided to taper off really slowly. Like over a year. Sadly that was about the time that both the pandemic and peri hit. Plus in hindsight I think I cannot manage without an AD, I was kidding myself. I thought I would be “proving” something if I could get off it.
Anyway I was down to a super low dose and started to get bad cyclical moods and bad anxiety again.
Went back on the Prozac at my old dose. Nothing happened! Aaargh. Increased the dose. Still nothing happened.
At the time I was starting HRT due to hot flushes and was on a medium dose.
I decided to try an SNRI (venlafaxine) to try to improve mood and also address hot flushes at the same time (the HRT dose I was on helped but I was still struggling with them). Venlafaxine is also a first line treatment for hot flushes for those unable to use HRT. I was unhappy about starting a new AD (especially as SNRIs are difficult to stop) but didn’t have much other choice.
After a couple of weeks, massive improvement in mood on the lowest dose of venlafaxine. That was about 18 months ago now. Much more stable both mentally and hormone wise. I am still peri so not exactly the same situation as you I know. I also had CBT just before I decided to start the venlafaxine which helped enormously with the anxiety.
Can I ask - do you have any other menopausal symptoms? Hot flushes etc? Your mood change could well be to do with declining hormones but not definitely. Have you ever tried any other types of AD? It is possible for ADs to stop working as they should. Prozac is particularly well known for it. Has your GP discussed changing ?
Hoping you feel better soon. It’s the absolute pits I know.
Hi VanillaLover,
I too have used Prozac in the past for a number of years approx 20! After much trial and error and extreme crippling depression symptoms until I found the right Ad to help me.
I also stopped them last July (tapered down with GP advice) and feel very similar to what you describe as in the timing of my stopping them coincided with drop in hormones although I felt stable without them until this year when peri/meno symptoms have increased. I too feel like I possibly can't manage without an Ad as depression/bi polar/mental illness runs in my family (my dad). I was fed up of the side effects too which was another reason I stopped them. But I guess if we need them then we need them! I am going to try Prozac again on a lower dosage and hope it helps me again like it has in the past. I am pleased you found the right Ad for you and that it helps you. Sorry for jumping in but just wanted to share.
Sallyyy
I know if I increased my Ad's in the past it could take a few weeks before I could feel the effect of this could this be the case with you ?
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Hello Sallyyy
I also take Venlafaxine which I was prescribed at the same time I started HRT. I was told that this AD is particularly good for reducing night sweats and I would agree with that.
I am post meno and I have tried many different HRT regimes and doses of HRT, I even came off HRT completely for a while but I continue to take Venlafaxine.
I hope you find the help you need and I wish you well.
K.
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I am so so grateful for the replies to this post.
I have gone back up to 50mg of clomipramine it’s an old tricyclic.
I had been on 25mg for 10 yes and then 18mg for another 2 years and very well. Busy job / happy at home etc.
I was actually ok mentally through peri. I did have night sweats etc in my late 40’s but they seem to have reduced in last couple of years.
I had only relapsed in the past when I either stopped ADs completely or got below 20mg.
I am going to slowly increase to 75mg. You can take much higher on this medication but I have never managed to take more than 75mg.
Everything is very difficult and I’m not getting any respite. I can’t believe I was ok a few weeks ago.
Thank you for the info about other ADs. I’m very scared that I won’t be able to get well again.
GP happy to refer to psychiatry but said will be very long waiting list. Going to look to see if can get private appointment if no improvement in two weeks. Have been on the 50mg nearly two weeks now.
I really appreciate the support x
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I am so so grateful for the replies to this post.
I have gone back up to 50mg of clomipramine it’s an old tricyclic.
I had been on 25mg for 10 yes and then 18mg for another 2 years and very well. Busy job / happy at home etc.
I was actually ok mentally through peri. I did have night sweats etc in my late 40’s but they seem to have reduced in last couple of years.
I had only relapsed in the past when I either stopped ADs completely or got below 20mg.
I am going to slowly increase to 75mg. You can take much higher on this medication but I have never managed to take more than 75mg.
Everything is very difficult and I’m not getting any respite. I can’t believe I was ok a few weeks ago.
Thank you for the info about other ADs. I’m very scared that I won’t be able to get well again.
GP happy to refer to psychiatry but said will be very long waiting list. Going to look to see if can get private appointment if no improvement in two weeks. Have been on the 50mg nearly two weeks now.
I really appreciate the support x
Good to hear you are going back on the Ad. I have taken Ads all my life and would not dream of trying to come off them. If they help then they can save lives.
So sorry to hear how difficult things are. I find it helps to take things one day at a time or I feel overwhelmed.
If you can book private therapy that will help so much and skip the waiting list too.
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This too will pass.
I have both organic and clinical depression. When my brain is low in the mornings for more than 3 days, I up to 5mg extra in the mornings. After 3-4 days my brain feels better.
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Thank you
*flossieteacake* I hadn’t actually stopped the ADs - was on a low dose. I’ve been back on the increased dose for two weeks now but no sign of any improvement.
I am going to go up slightly higher (GP aware) and then give it another two weeks but after that may need to switch to a different one.
I really appreciate these messages. I had started to fear that now I’m two years into full menopause that this might be how I am now with no hope of getting better.
I’m trying to be rational and think that women must still improve on the right anti depressant at this age.
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Thank you
*flossieteacake* I hadn’t actually stopped the ADs - was on a low dose. I’ve been back on the increased dose for two weeks now but no sign of any improvement.
I am going to go up slightly higher (GP aware) and then give it another two weeks but after that may need to switch to a different one.
I really appreciate these messages. I had started to fear that now I’m two years into full menopause that this might be how I am now with no hope of getting better.
I’m trying to be rational and think that women must still improve on the right anti depressant at this age.
Oops. sorry for the confusion. If after six weeks you do not feel any improvement then that will tell you if you need to try a different one.
Never think you will always feel this way! We will have times were things feel bad but they will not last. Nobody is too old for an AD and they can be life changing in the sense they can give people the lift they need to be able to feel okay.
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I was on citalopram and hrt for years. My mood was so low i went back to the gp who said i was depressed and it wasnt my hormones so she gave me fluoxetine 20mg.
I took the decision to stop the HRT to try to work out what is going on with my body and I feel really good. My husband said I am back to the happy bubbly person I used to be and he doesn't need to watch what he is saying anymore.
Isn't it interesting how we feel we need HRT.
I don't want to speak to soon but so far so good. I will stick with the ADs
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I was on citalopram and hrt for years. My mood was so low i went back to the gp who said i was depressed and it wasnt my hormones so she gave me fluoxetine 20mg.
I took the decision to stop the HRT to try to work out what is going on with my body and I feel really good. My husband said I am back to the happy bubbly person I used to be and he doesn't need to watch what he is saying anymore.
Isn't it interesting how we feel we need HRT.
I don't want to speak to soon but so far so good. I will stick with the ADs
What lovely news! I am so happy to hear you are feeling better MollyMoo. :)
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Thank you so much for posting Mollymoo - I’m glad you are feeling better. How long did it take for things to improve.
I think the HRT publicity has generally been really positive for women but I do think there is a part of it that can cause problems when it’s not the answer to everything at this age x
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I was on citalopram and hrt for years. My mood was so low i went back to the gp who said i was depressed and it wasnt my hormones so she gave me fluoxetine 20mg.
I took the decision to stop the HRT to try to work out what is going on with my body and I feel really good. My husband said I am back to the happy bubbly person I used to be and he doesn't need to watch what he is saying anymore.
Isn't it interesting how we feel we need HRT.
I don't want to speak to soon but so far so good. I will stick with the ADs
Hi hunni,
Fluoxetine has helped me in the past too! And this is such a lovely post to read as you now are feeling back to yourself and found what you needed to help that happen. I am truly so happy for you and long may it continue. Take care xxxx
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Thank you so much for posting Mollymoo - I’m glad you are feeling better. How long did it take for things to improve.
I think the HRT publicity has generally been really positive for women but I do think there is a part of it that can cause problems when it’s not the answer to everything at this age x
Hi Sally
I felt an improvement in my mood within a couple of weeks. It's been about 8 weeks now,still no hrt and the only ymptoms I am getting are waking in the night with a drymouth, very hot when I go for a walk but not flushing, a little dry below but I can cope with all this.
I do know that there was benefits from the hrt because my bone health improved but I am going to keep an eye on this and if all good in 6 months I will stick with anti d,s rather than HRT xx
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R U treating the 'dryness below'? Let us know how you get on.
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Hello I’m just restarting this post if that’s ok. I continued on clomipramine and increased to 75mg but unfortunately couldn’t sleep at all so dropped down to 60mg.
Had started to see a bit of improvement but sadly this stopped nearly two weeks and severe anxiety is back.
Dr has said to try for another 3 weeks but then may need to switch which I’m terrified about because I respond badly to ads initially.
Sertraline and citalopram have been suggested as possible options.
Would really appreciate any experience / advice. I’m two years post menopause and doing all the self help too.
I’m really struggling :'(
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It could be you need the full six weeks to see an improvement. Do you think you can wait? If you feel the side effects are too bad then you can.always stop them.
It is unfortunate it can take time to find the right AD but hang on in there as you will find it.
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Hi - I’ve been on the increased dose for 10 or 11 weeks. Things had started to improve a bit but have gone backwards again for last couple of weeks.
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Hi - I’ve been on the increased dose for 10 or 11 weeks. Things had started to improve a bit but have gone backwards again for last couple of weeks.
Oh I see. I am sorry to hear this. Could it be something outside this such as you are anxious about something?
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You are on the right road. The blips/set backs are often worse when we have felt improvement. It may be that in a few days you will feel more settled. When I had bounce back symptoms I would go into the doldrums, "Oh NO, NOT again" ........ however, it never became worse than prior to taking the meds and didn't last for long.
I take escitalopram 10mg at night and 5mg in the morning; if I wake feeling down for more than 3 mornings in a row I up the5mg to 10mg at breakfast which usually helps. Once I feel stable I drop to 5mg at breakfast.
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Thank you both for replying. It’s so scary to be in this position when I’m already on the medication. (I’ve been in this position twice before and even though there were always little set backs it’s always kicked in by now.)
I’m going to really try all the other self help things for the next two or three weeks to see if things calm down.
Escitalopram has also been mentioned as a possibility as well as sertraline and citalopram. How do you find it for anxiety ?
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My teen daughter was put on Sertraline for anxiety two years ago. It has been life changing for her and she has now reduced from 100mg to 50mg.
GP did say that Sertraline helped more with anxiety.
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That’s useful to know Tinkerbell. I’m glad your daughter is doing well.
How did she find it with initial side effects?
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I have been using citalopram very low dose since last August and it has definitely helped. Although I am still in peri menopause and only really got the anxiety mostly under control once I started hrt. Probably different for you though given you are post meno. Escitalopram is similar to citalopram, some would say it is better. You usually have a lower dose than with citalopram and side effects are meant to be less. Saying that, I am very sensitive to medication and the only real side effect I get with citalopram is a dry mouth for about 5 hours after taking it and less intense orgasms. I would definitely give another AD a try if needed, just make sure you do a proper taper from the one you are on. The GP may be able to give you something short term to use ad hoc while you make the switch, e.g. to deal with any acute anxiety that arises.
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Hello Sallyy,
I have just started on mirtazapine, due to awful and worsening cyclical moods. Am only on day three. I initially took half a tablet at night, but for some reason I was awake most on the night and needed to sleep most of the next day! So I then just took a 1\4 tablet and slept better. The next days I was a bit drowsy at first but this wore off. Early days. I am anxious about potential weight gain on this particular med, but option wise it seems the best choice.
I just say to myself ( and I 100% believe this) that I need to take this for my mental health. I will carry on with it as it is a much needed support in my life right now.
I wish you well
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Ooh Sarah T, I forgot to say that on your post, I started on half of even what the initial dose of mirtazapine was as had been told it was quite strong by another user! I hope you feel better on the lower dose. Did your GP ask you to increase after 14 days? Mine did, but I didn't end up taking it that long because of dizziness. However my understanding is its one you need to increase gradually to the full dose x
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My memory of taking Mirtazapine is that I started straight off on 15 mg. I immediately started sleeping through the night which was wonderful. Yes to feeling extremely tired in the day time but whatever you take there will be some sort of side effects to start with. They do gradually wear off tho and then you start to feel well again. I think whenever you start an AD you have to expect some start up side effects. The Mirtazapine was great for me because finally I slept, I could eat, I wasn't nauseous, and no crashing of libido!
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My Dr did say I could start on a 1\4 or 1\2 dose . But blimey it was very strong for me on the half. Definitely better on the quarter then I can always build up if I feel the need, but thanks for the infringer on that Penguin.
She said I can just use it on the week leading up to my period to ease the extreme pms symptoms. I know generally Ad's work on a cumulative effect, but let's wait and see. I do not feel depressed.as such 3 weeks of the month, just when hormones to crazier so would prefer an as and when dose.
Time will tell..and thanks Gnatty, I went for this med purposely to try to save the bit of libido I have left.😉
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It’s really interesting to see all the thoughts on this. It isn’t discussed very often which is a shame for those of us who do need ad’s.
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Sallyy I agree,
I love this forum for just that reason. A chance for women going through many different difficulties ( and successes) and symptoms, but having a safe place to be totally honest and supportive. Offering advice and their own experiences both good and bad.
Being able to speak freely of our health, both physical and mental\emotional is vital. X
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I’m just messaging again because unfortunately things haven’t improved and I am having awful lows and anxiety.
My dr is away for two weeks but when they are back I think I will need to change.
I’m really scared to switch anti depressant but I’m not sure I have any choice.
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I’m just messaging again because unfortunately things haven’t improved and I am having awful lows and anxiety.
My dr is away for two weeks but when they are back I think I will need to change.
I’m really scared to switch anti depressant but I’m not sure I have any choice.
I really am sorry to hear you are feeling so low and anxious. Am I right in thinking you have been on the increased dose of the AD for3 months now?
It is hard to change antidepressant but you never know, a new one could be perfect for you. It took me many years to find one that suited me.
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@flossiegate I’m so sorry I didn’t see your reply. I have an appointment next Monday to discuss options. I really struggle with reducing and starting ads and I know that I’ll need to take time off work again.
(Re. Timings - it’s just over 4 months since I increased my dose. I made a mistake in one of my earlier posts - I started increasing the dose at the start of April.))
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@flossiegate I’m so sorry I didn’t see your reply. I have an appointment next Monday to discuss options. I really struggle with reducing and starting ads and I know that I’ll need to take time off work again.
(Re. Timings - it’s just over 4 months since I increased my dose. I made a mistake in one of my earlier posts - I started increasing the dose at the start of April.))
I am so pleased you have a DR appointment soon. I really hope they are going to be supportive. I too struggle with having to taper and start a new AD. It can be difficult for the body to adjust.
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Hi sallyyy, I'm really pleased you post this but obviously not pleased you are suffering and needed to! I have felt totally rubbish for at least 3 quarters of my life, I'm not sure what it's really like to be happy. I have previously been on AD (for post natal depression) 27 years ago. I broke down at my hairdressers a couple of months ago (I've never done anything like that before and don't tell me when I'm not ok) and she told me to call my GP and discuss HRT. Anyway I did out of desperation and the GP felt it was more depression and anxiety than menopause, I don't have many perimenopause symptoms really. She left me to think over if I wanted AD or HRT. My husband was very against AD so I went with HRT. 1 week into that I developed chronic hives and I'm sure it was as a result. I did a post on that so won't go over again here. I came straight off HRT and am back to square one. Well worse than square one as I still feel so utterly sad and low in myself with added chronic hives which has also decide to pitch up on my face.
I wished I tried AD first which my GP also thought I should do first. I don't want to think about that now though as I'm so scared they will make the hives worse.
I really hope you get the help and answers you need. I'm sending you a massive virtual (((HUG)))
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My GP oversees the ADs. She is very nice but I think I may need to consider paying to see a psychiatrist. The NHS wait locally is very long.
Thank you for sending the kind messages. I can’t imagine feeling well again.
(I have increased the dose a couple of weeks ago @CLKD.)
Does anyone else take anti depressants ?
Have you tried vita minds? You can self refer there.
You'll get an initial assessment with a few days then if you go on to the waiting list for help you can have a few sessions with someone to tide you over as waiting list is so long. Have a Google of it
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Hi Penguin, do you mind if I ask what dose you are on when you say very low dose? Interested to hear that a very low dose can help...x
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Hi CherryC, I take 10mg daily. The standard dose is 20mg, with a maximum of 40mg! I was initially meant to start on 10mg and then increase to 20mg, but after discussing with the GP, we decided it wasn't necessary to increase.
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Thank you Penguin, that's really interesting. Do you remember if you had any side effects when you first started on it and how long they lasted?
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Bit of indigestion and a dry mouth. Still have the dry mouth but it eases off after peaking about four hours after taking it. Also need to wee more in the morning after taking it. I didn't feel the anxiety got worse when I started taking it, but it did take awhile to feel better, maybe six weeks or so. Now I still get a bit of anxiety in the morning, but usually a nice calm feeling by mid pm. I started hrt five months after starting citalopram though, and I do believe I needed both to really get a grip on the anxiety. So basically I do still have the dry mouth and need to wee more for about 5-6 hours but the pros definitely outweigh the cons.
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When my mood is low for more than 3 mornings in a row, I add 5mg - usually I take 10mg at night and 5mg at breakfast, adding that 5mg really helps. The brain is an organ, out of sight out of mind, which needs nourishing. As well as ADs ........ I also have an emergency go-to anti-anxiety pill to swallow when anxiety floors me.
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CLKD, is it citalopram? I have struggled to cut mine, it doesn't have a dividing line, does yours?
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Escitalopram - 10mg has a cutting line.
Why do U need to cut, mayB try taking on alternate nights?
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I was planning on starting to slowly taper off in the near future but my GP says 10mg is the lowest pill size. I think you're right though, alternate nights would be the way to go.
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I tried to stop but have a 22 month cyclic illness: feel bad, take meds., feel better, stop - OK for a few months B4 plumetting again. I wouldn't consider stopping after all these years.
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Yeah I'd be worried about a recurrence too. My anxiety issues and feeling constantly down always seem to ramp up in the autumn. Such a shame as was always the best time of year for me, now I just associate it with my mum getting sepsis and things start spiralling downwards. Think I've just talked myself out of reducing until the start of 2024 now!