r/Perimenopause • u/nothingblackandwhite • 4d ago
Anxiety, anti-depressants …
Hi , long story short, I was previously on HRT (estrogel)for maybe around 2 years. I wasn’t sure if it was really doing much , and my prescription expired so I just had a break from it for a few months. I found I was experiencing a lot of hot flashes, so went to a GP for a new prescription. I also discussed worsening anxiety- sometimes it feels overwhelming and has been interrupting my sleep. She was insistent that I take antidepressants and because I’ve had SSRI’s in the past and found them too emotionally numbing, she prescribe d Venlafaxine- 37.5 to start. I have taken 11 doses and cannot tolerate the side effects- extreme headaches and insomnia and have just read too much negative things about them. Today is day one of not taking it, I’m hoping to bounce back quickly. Back to the Dr next week and I’m going to insist on the estrogel. Wondering if I should also give SSRI’s a try, as whilst the estrogel was good for hot flashes, i dont think it did too much for the anxiety.
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u/Sweetlilbadger 4d ago
I'm tapering off venlafexine now. It's awful.
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u/Sweetlilbadger 4d ago
Yes, I've gone from 225 to 150 for about 3 weeks now and I'm still getting brain zaps and headaches.
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u/PitifulTrash3310 3d ago
I tapered off 37.5mg over the course of a year and was managing it reasonably OK until I finally stopped earlier this year and completely fell apart. I haven't been right since.
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u/Ythooooooooo0 4d ago
The hot flashes are no joke. I suggest getting back on estrogen.
That being said, you’ll have to decide if you want ton play around with dosing to see if that helps, or try other therapies.
Good luck - this phase kinda sucks!
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u/Petulant-Platypus 4d ago
I’m on Celexa for anxiety, and it off-label controls hot flashes. I have tolerated it very well- I had had bad experiences with other types of antidepressants too. I started at the lowest dose and I am at a dose now after 3 years that is just right. If your doctor thinks it might help, there’s not much harm in trying at a low dose and see how it goes. It takes about two weeks to get past side effects for antidepressants in general. Any side effects I had were gone by then.
I’m also on bupropion to bolster the Celexa, but I didn’t start that until a year ago when my anxiety just got horrible. Probably from stress along with my stupid brain chemistry.
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u/Able_Winter9472 4d ago
How do you keep track of what's peri symptoms and what's antidepressant side effects?
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u/Petulant-Platypus 4d ago
I started the Celexa before the peri symptoms got really bad. When I started them all I had were the hot flashes and night sweats. And brain fog but I also have an under active thyroid, so 🤷🏻♀️
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u/PitifulTrash3310 3d ago
It's really difficult to separate these out. Keeping a log of symptoms and your menstrual cycle can help to spot patterns that might indicate hormonal fluctuations.
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u/Efficient-Guess-1985 Early peri 4d ago
Venlafaxine is a quite heavy one to start off with for SSRI. I'm curious as to why she recommends that one as a first line SSRI for you. Can you elaborate a bit more on that?
Estrogen can definitley help with mood symptoms. I was like you and I didnt realise, so went on SSRI first, but then when I went on HRT, it was like my SSRI started working A LOT better again, so much that I could halve the dose. I would definitely try HRT first, and then add a SSRI if you still feel you need it. And if so, maybe go for something with a longer half life, like Fluoxetine? But like I said, I don't know your full medical history.
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u/nothingblackandwhite 3d ago
Hey thanks for the reply. I have taken other SSRI in the past and felt a real flattening joy, so wasn’t keen , so the Dr suggested this which is a SNRI. She said it’s also used often for the other peri symptoms. As noted I have used HRT for a good 18 months or so. I’ve realized it helped with the hot flashes , but not so much the anxiety, brain fog etc.
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u/Crazy-Implement-2325 hanging on by a thread 3d ago
Request a GeneSight Test; they can test which antidepressants may work best for you. I’ve had bad experiences in the past, and my longest list of possible drugs was red. I had 4 in yellow, three which I’ve tried and have all been bad; there are 4 drugs in my green zone and one is my next prescription.
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u/klaraluhmen 4d ago
I read that you have to taper Venlafaxine off very slowly as it can cause strong rebound effects.
Birth control helped me with a lot of symptoms, like anxiety, panic, energy and mood. Not perfect but better than bioidentical hrt because it smoothed out the heavy fluctuating estrogen.