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[flutterby]

Hi I was on HRT for 16 years I am now 69 but still having hot flushes and night sweats and not sleeping as well as I did when I was on HRT
I have tried all sorts of alternatives for anxiety and now for the insomnia (worse since beginning of year). I’ve never wanted to take medication for the anxiety even though I’ve had problems most of my life.
After a 90 seconds telephone consultation with a locum GP in August he gave me 15mg number mirtazapine which after reading about it I was frightened to take. Two nights ago I took one in desperation and did sleep for 2+ 6 hours but I was so groggy the next afternoon I felt I couldn’t continue with them as I was going to have to drive for 3 hours on Friday. Last night I slept from 5am to 8am and realised I was having so little sleep that I cancelled us going away anyway (argument with husband now talking but feel he doesn’t understand)
I’m seeing my own GP face to face next week for which I’m grateful but I want to be well informed.
I was wondering if citalopram long term with something short term for the insomnia would help.
I would so appreciate any advice or experiences
Flutterby x

[Postmeno3]

I don't know anything about these medications, but just wanted to acknowledge your post and wish you well with everything. Is it right that these medications are better taken before last thing at night? Also, have you had your magnesium levels checked? Some magnesium citrate could be helpful.

[Dotty]

Hi if HRT suited you then there is no reason why you can’t carry on taking it. x

[flutterby]

Thank you Postmeno
I took the Mirtazapine at bedtime, I always take a magnesium tablet late on. Tried loads of sleep hygiene things
Hi Dotty - coming off HRT was my choice I had an ovarian cyst and a uterine polyps which caused a lot of bleeding I just felt it was time. However I didn’t think I would still be having the menopausal symptoms at this age 😢

[sheila99]

Sadly there are women who continue to suffer meno symptoms for years. Perhaps have a chat with your gp but I would have thought hrt would be a more appropriate treatment. Anxiety and insomnia were my worst symptoms so I understand how awful it is - there's no way I'd want to go back there again.

[Cazikins]

Hi Flutterby 
I was in a similar position earlier this year regarding the anxiety. I felt everything was crashing down on me & couldn't cope with it. It was out of control & I felt over whelmed with everything.

I have always shied away from anti depressants & thought no I can get through this on my own, so I struggled for a few more weeks. By the end of July I had a tel cons with my GP. I emphasised I was not depressed but felt stressed with anxiety & out of control with my life & those around me (the control freak that hides with me  . She listened & offered talking therapy... nah not for me. so then she suggested trying 10mg of Citaolpram for 2 weeks but did warn me it could make me feel very tired to begin with but try & persevere with it. They do & still do make me feel incredibly tired but I am having checks to see if it is anaemia as I have low B12.
 
It was a struggle to begin with but after 2-3 weeks I was noticing an improvement in my mood. I realised I was not getting so worried about things... so what if I didn't have fresh milk in the fridge, does it really matter that I forgot to put the washing out when I got home from work, OK so what if I had planned to do things on my list but hadn't done them all.... throw away the lists Cazikins !!

After 4 weeks my doc increased to 20mg per day. I couldn't understand the logic in increasing but "whatever" - I had little to lose. Soon after that my mood lifted & I felt better about life for the first time in months. I wasn't worrying about things that were not my problem or not my responsibility. I concentrated on getting myself better & sod it if the people around me didn't like it. As it turned out  I did get support from my friends & family but only when I told them how I truly felt.

Give them a try flutterby but don't expect things to return to normal quickly. I keep a diary & score my days out of 10. I was at 4/10 but now feel more like 8/10.

As for the HRT, I did come off them for 3 months last year but the bloody flushes came back so l I'm back on them again (low dose femoston combined) but I cut them in half. It takes off the edge of the hot flushes.

I hope you find something to help you - Citalopram has certainly helped me.

Keep us updated.

Love Cazikins xx
 

[flutterby]

Thank you for your reply Sheila I will discuss all options with GP
Cazikins - sorry to hear you’ve been struggling with anxiety too. Thank you for the info on citalopram. Did it have a positive or negative effect on your sleep pattern?
Flutterby x

[flutterby]

Went to GP today (2 hours sleep last night) and had chance to tell her about the insomnia and the generalised anxiety. She said I could take the mirtazapine (reluctance due to increased appetite) I mentioned citalopram but she thought it was best to try sertraline 50mg. I asked if it was possible to prescribe a mild sleeping tablet with it and she said it was not advisable and one of the contra indications was death!
She said an antihistamine based sleep tablet would be ok, but I should ask the pharmacist which one.
Pharmacist said not recommended at all.
Now I feel I’ve gone backward as from what I’ve read the sertraline commonly causes insomnia
Flutterby x

[CherrySG]

Flutterby, I was not sure which exact combination of antidepressant and sedative causes death? Can't be citalopram with diazepam or citalopram with zopiclone as both are often prescribed together to get people through the first fortnight of antidepressants. I've taken both and am still walking around.

I've never tried Mirtazapine but have heard it's quite sedating, and can understand why a long drive would be out of the question when newly on the stuff. I have that with citalopram. For some the tiredness goes away.

Sertraline I dimly remember as less sedating than any of the others, but it's such an individual thing. I do hope you can get some quality sleep soon.

[flutterby]

Hi CherrySG I am not sure whether she meant all SSRIs or just Sertraline
It did seem a dramatic thing to say. Maybe it’s because I’m older - 69. After another night of 2 hours sleep I’ve realised that even though there is increased appetite I’ll work with it and take the Mirtazapine that was originally prescribed
Flutterby x

[CherrySG]

Oh, I hope you get a good night's sleep on the Mirtazapine, Flutterby.

I'm so tired on citalopram I can't manage, even on 5mg! I could just about cope with it 10 years ago but I'm trying fluoxetine now. There must be one out there that doesn't cause fatigue!

[flutterby]

Hi CherrySG I’m almost too afraid to say but the anxiety is vastly reduced and although I didn’t get to sleep properly until 3am (in bed at about 11) but then slept for 5 hours.
As I had had a good night sleep when I cut a bit off the tablet - I thought I’d try it again and last night I went to sleep quite quickly and slept well.
I’ve felt good today. I know that Mirtazapine works on the brain differently at lower doses and is more sedating at 7.5mg apparently.
Hope the fluoxetine works for you and you don’t feel so tired
Flutterby xx

[Gnatty]

I take 15mg Mirtazapine and I found the increase in appetite only lasted a short while and then went back to normal. The only weight I gained was the weight I lost because of anxiety. If anything I am stil two or three pounds less than what I used to be. I had a wobble with the anxiety a few weeks ago, but have sorted this by applying by oestrogel to inner forearms. I think I am now absorbing it better!

[flutterby]

Hi Gnatty thank you for sharing your experience with Mirtazapine.
Flutterby x

[Stillsearching]

I was prescribed sertraline about 15 years ago. They sent me absolutely yampy and for 18 months I felt wired with ittle need for sleep. I went cold turkey on a holiday to the sun and then started to take 5HTP for a couple of years before weaning off them. I also invested in a SAD lamp which I found very effective  For sleeping problems I will take a Boots Sleapeze for 2 or 3 nights which is the same as Nytol. Tesco and Asda do them same drug under their own label.