Could Antidepressants Make Menopausal Symptoms Worse
Anne explains, “There is evidence that SSRI antidepressants can exacerbate some menopausal symptoms, particularly poor libido and weight gain, which are very common due to the hormonal shifts. They are also much less effective at controlling menopausal mood disorders than is generally recognised.”
Diane agrees, “Many women say that antidepressants when prescribed for the psychological symptoms of menopause simply dont help, or make them feel numb or flat.”
“Antidepressants didnt help at all they just made me feel a bit numb and slightly disconnected from everything.”
Katie Taylor described her experience using antidepressants during the peri-menopause, she said, “I was offered antidepressants during the four years when I was suffering with terrible peri-menopause symptoms, which were misdiagnosed as depression. Antidepressants didnt help at all they just made me feel a bit numb and slightly disconnected from everything.”
After visiting agynaecologist, Katie was diagnosed with peri-menopause and prescribed HRT. She said, “I was like a new woman and back to the old me within a month. I set up my online platform The Latte Lounge so that no other woman would waste good years of life trying to figure out what was wrong with them.
Possible side effects of antidepressants
Cardiovascular side effects and gastrointestinal side effects
Nervousness, insomnia, restlessness and nausea
Weight gain and headaches
Dry mouth, nausea, constipation, diarrhoea and appetite problems
Criteria For Considering Studies For This Review
Types of studies
We will include randomised controlled trials, published and unpublished, without restriction on language. RCTs with a crossover design will be eligible for inclusion if they have data prior to crossover available.
Types of participants
Women who attain natural or surgical menopause alone or with hysterectomy), with menopausal symptoms in the perimenopausal or postmenopausal period.
Perimenopausal women are women with spontaneous menopause who have experienced irregular menstruation within the previous 12 months.
Postmenopausal women are women with surgical or spontaneous menopause and amenorrhoea for more than 12 months.
Trials will include women with menopause due to primary ovarian Insufficiency, radiation, or chemotherapy and both with or without a prior history of disease .
Previous hormone therapy within one month of commencement of study
Types of interventions
1. Antidepressant medications versus placebo, no treatment, oestrogen therapy, combination of oestrogen and progestogen, gabapentin, clonidine.
2. One antidepressant versus another antidepressant
Types of outcome measures
1. Hot flushes : i.e. frequency, severity, presence versus absence or a combination measure of frequency and severity. This is measured by
change in hot flushes scores
change in frequency of individual hot flushes or severity of individual hot flushes scores.
Daily hot flash diary
Kupperman Menopausal Index
How Antidepressants Work
The exact mechanism of how SSRIs and SNRIs decrease menopausal symptoms is unclear, but women taking them often swear by their effectiveness.8 Some studies of SSRIs and SNRIs have demonstrated that 50-60% of women taking them have noticed benefits in reducing hot flashes and night sweats.8
While we donât know the specific physiological reason for antidepressant effectiveness, we do know that when estrogen drops, like during menopause, there is a decrease in the level of endorphins. Endorphins are chemical messengers that can reduce stress and regulate feelings of happiness, and even euphoria.
When there is a reduction in estrogen, there is also a reduction in endorphin production. If endorphin levels are very low, the body temperature increases. If the endorphins are very high, then there is a decreased body temperature.4 As hormone levels go up and down with menopause, your body may reset its thermostat set point – which can lead to your body thinking it is hot or cold when it actually isnât. The result is an overreaction, a hot flash or night sweat, to an internal thermostat that is out of whack.8
In women with underlying depression, hot flashes, and night sweats taking antidepressants can reduce the number of hot flashes and improve their ability to cope with their overall mood and depression.8
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When To Seek Help
Its never too early to discuss your menopause symptoms or mood concerns with your healthcare provider. As you get closer to menopause, its a good idea to start reviewing symptoms to look out for and treatment options for the future. If mood symptoms become frequent and begin to impact your day-to-day life, make sure to discuss this with your provider.
Treating Menopause: Beyond Hormone Replacement Therapy
Want to avoid hormone replacement therapy? Find out about other drugs that have shown promise in treating menopause symptoms.
Ever since results from the Womens Health Initiative study raised safety concerns about the side effects of estrogen and combination hormone replacement therapy , many women have been looking for alternative ways to treat their menopause symptoms.
Beyond Estrogen: Other Options for Menopause Symptom Relief
Simple changes like eating right, getting enough sleep, and exercising regularly are probably the best non-hormonal treatments for keeping menopause symptoms at a manageable level. However, when lifestyle changes arent enough, some prescription medications such as antidepressants, anti-seizure medications, and blood pressure medications have shown promise as menopause treatments for symptoms such as mood swings and hot flashes, says Wendy Klein, MD, director of education at the Virginia Commonwealth University Institute for Womens Health and associate professor emeritus of internal medicine, obstetrics, and gynecology at VCU School of Medicine.
Heres a look at common menopause symptoms and non-hormonal therapies that may work to alleviate them.
Help for Hot Flashes
Easing Vaginal Dryness
Promoting Better Sleep
Other options to try include:
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Data Extraction And Management
Two independent authors extracted data from the eligible studies into a database of pre-determined variables of interest, including mean age , mean body mass index , duration of antidepressant treatment , and ethnicity . The corresponding authors were contacted by email to request additional data on at least two different occasions 1 week apart whenever variables of interest were not available.
What To Look For When Choosing Menopause Supplements
When choosing a menopause supplement, look for ingredients such as black cohosh, red clover, and saint johns wort. These ingredients were found to be highly effective in peer-reviewed clinical trials. A lot of menopause supplements also contain phytoestrogens from soy and other plants, but their efficiency is still unknown.
Other than that, you will find many different ingredients in menopause supplements that treat symptoms such as hot flashes, night sweats, depression, and vaginal dryness. Because the FDA does not regulate dietary supplements, it can be hard to tell if the ingredients in your product are safe.
However, some products are manufactured in an FDA-approved facility and by the Good Manufacturing Practice guidelines, which is a sign that a product is safe for use.
Furthermore, look for products offering a money-back guarantee as this also is a sign that the manufacturer has your safety and satisfaction in mind. This also means you wont be throwing money away on products that dont offer any relief.
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Is Moclobemide A Good Antidepressant
Adverse effects. The incidence of adverse events is not correlated with age however, adverse events occur more often in females than in males. Moclobemide is regarded as a generally safe antidepressant and due to its favorable side effect profile, it can be considered a first-line therapeutic antidepressant.
Similar to B vitamins and vitamin D, magnesium shortage is really common in people experiencing depression, and low degrees might be connected to depressive signs and symptoms. Brief for 5-hydroxytryptophan, 5-HTP is an amino acid that your body utilizes to produce serotonin, whose label is the pleased chemical. Like serotonin, your body produces 5-HTP normally. Your body uses it to generate serotonin, which assists enhance your serotonin levels, which, in turn best depression medicine for menopause, can elevate your mood. However when taken as a supplement for depression, evidence is limited as to its performance. Not only are they not FDA-approved, theyre known to create extreme neurological conditions, among other major negative effects. Alterations in intestinal vegetations have been linked in mood problems, although the system is unclear.
Along With Menopause What Increases A Persons Risk For Depression
Depression is very common, and there are many risk factors outside of menopause. Depression is often due to a combination of genetic and environmental factors. Other risk factors for depression include:
Family history of depression or other mood disorders
Death or loss
Moving or talking slowly
Thoughts of hurting yourself or thoughts of suicide
Depression may be diagnosed when these symptoms occur most days and persist for more than 2 weeks.
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Best Herbs For Anxiety And Depression During Menopause
Most women experience menopause after the age of 40 and spend a third of their life in this phase. It is a natural and important part of any womans life. Still, that doesnt always make it easy to deal with.
The changes that come with menopause affect a womans life physically and emotionally. The most recognizable changes are hot flashes, mood swings, and restless nights. But, what many people may not realize, is that menopause may also bring with it ANXIETY, PANICATTACKS and DEPRESSION.
What Is The Best Antidepressant For Menopause
The best medication for menopause-related depression will depend on many factors. Its a good idea to discuss your medication options with your provider. Medications that may be used to treat menopause-related depression include:
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Description Of The Condition
Menopause is defined as the permanent cessation of menstrual periods diagnosed after twelve months of amenorrhoea, not associated with pathological causes or the use of hormonal contraception . Menopause can also be induced by surgery, radiation or chemotherapy. Menopause is often associated with vasomotor symptoms, including hot flushes, night sweats and sleep disturbance . Approximately 75% of postmenopausal women experience hot flushes that persist for six months to five years, with approximately a third of this group being severely affected. Other shortterm symptoms of menopause include altered sexual function, urogenital atrophy and psychological symptoms such as low mood and anxiety . Hot flushes have significant impact on quality of life and may interfere with daily activity . The menopausal transition is the time before the final menstrual period and is associated with irregular cycles, hormonal instability and symptoms. Transition to menopause is a complex physiological process that typically begins in the mid to late 40s and most commonly lasts four to five years. Hot flushes are described as spontaneous sensations of warmth, variable in frequency, duration and severity, affecting the face, neck and upper chest, and are often associated with palpitation, sweating and anxiety . Studies have shown independent associations between poor sleep and hot flushes, anxiety, depressive symptoms and lower E2 levels .
Benefits And Risks Of Hormone Replacement Therapy
The main benefit of HRT is that it can help relieve most menopausal symptoms, including hot flushes, brain fog, joint pains, mood swings and vaginal dryness.
It can also help prevent thinning of the bones, which can lead to fractures . Osteoporosis is more common after the menopause.
Some types of HRT can slightly increase the risk of breast cancer and blood clots in some women. You need to discuss whether you have any risk factors with a doctor or nurse.
Evidence says that the risks of HRT are small and usually outweighed by the benefits.
Your GP can give you more information about the risks and benefits of HRT to help you decide whether or not you want to take it.
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Side Effects Of Antidepressants
Gabapentin and pregabalin can cause dizziness. Clonidine can have some side effects including hypotension, dizziness, and rebound hypertension.8 SNRIs can potentially elevate blood pressure and regular monitoring of blood pressure is needed. Because of the variable adverse effects and efficacy of SSRIs and SNRI drugs, if any one of these drugs is not effective or well-tolerated, another drug can be prescribed.8
Can My Antidepressant Help Prevent Severe Covid
Another criticism is that the researchers did not examine how antidepressants affect depression subtypes.5 The diagnosis of depression says nothing of the cause of depression, writes Gordon Parker, just as a diagnosis of major breathlessness does not specify whether breathlessness is caused by asthma or pneumonia.
Why does this matter? Because treatments helpful in some subtypes of depression may not be effective in other forms of depression .
In contrast to the view above, a 2015 paper found a very significant overlap in how people with different subtypes of depression respond to treatment the authors concluded, subtypes may be of minimal value in antidepressant selection .6
Aside from subtypes, another issue is the applicability of the reviews findings. One writer argues the findings of this meta-analysis do not make it easier to choose an antidepressant, given that the most effective medications were not necessarily the most acceptable ones, and the most effective one carries major overdose risks.7
Other researchers, like Parikh and Kennedy, have criticized the statistical method used in the study, noting that while it has many advantages, it does not allow for analysis at the individual patient level and so cannot provide finer detail on who might preferentially respond or who might be more vulnerable to side-effects .3
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How To Choose The Best Menopause Supplements
Because most BDS for menopause symptoms rely on similar ingredients, youll want to focus on the product manufacturer and quality when choosing your product.
When choosing top rated menopause supplements, make sure that the product manufacturer is reliable and trustworthy. You can easily determine a manufacturers trustworthiness by looking at the info provided on their website.
Is there a physical address and contact information?
Are there any details regarding product manufacturing?
The more information was given, the higher the possibility that you are dealing with a responsible company that does not sell ineffective and contaminated products.
You also need to look carefully at the product description, the ingredients listed, and the studies behind their efficiency. When it comes to buying health products, taking safety precautions is of utmost importance.
Discovering The Best Treatment For Menopausal Depression
It takes a great deal of expertise to unpack all the potential risk factors for a woman who experiences depression during perimenopause. Thats why the best treatment for menopausal depression might be different for every individual. But regardless of what may be causing your depression, a comprehensive approach to treatment will likely be the best path forward.
If you are just beginning your journey, your goal should be to collect all the information you possibly can about your symptoms and their possible causes. Have a full physical done by a trusted health care practitioner, including comprehensive blood tests to identify health conditions that may be affecting your mood. Meet with a psychiatrist to discuss a possible diagnosis and their treatment recommendations. Have your hormone levels tested by a specialist in hormonal health. With a complete picture of your physiological and psychological health in place, you can determine what the next steps should be.
All things considered, there is plenty of hope for women who struggle with menopause-related depression. There is a wide range of psychotropic medications on the market proven effective for treating depression, and psychotherapeutic modalities like cognitive behavioral therapy are known to reduce depression in menopausal women. Treating sleep disturbances and engaging in mind-body practices like yoga and meditation can also help alleviate symptoms.
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Menopause And Mood Disorders
Menopausal hormone fluctuations are problematic. Add into the mix a womanâs life stresses, interrupted sleep, weight gain, and signs of aging and you have created a perfect situation for emotional distress, which can lead to anxiety, mood swings, and depression. Menopausal women often report symptoms of depressed mood, stress, anxiety, and a decreased general happiness. Those are not feelings that should be ignored or that you should have to endure.
This phase of a womanâs life often marks significant life changes that can adversely impact their mental health too.3 Children leaving for college, helping aging/ailing parents, facing increased career demands, and now Covid-19.4 This combination of physical and environmental changes poses an increased risk of suicidality.3
Anxiety, moodiness, and depression are some of the most commonly reported issues in women aged 42-52. But there is a recognition gap between these symptoms and their relationship to menopause. This confusion may be due to a stigma surrounding menopausal transition, loss of youth, or vitality. Additionally, when the words âmoody,â âanxious,â âdepressedâ are used, it sounds like an insult. Who would even want to admit to feeling this way?
Perimenopause impacts both a womanâs mind and her body. It is critically important for women who are experiencing anxiety and depression in their late 30s and early 40s to recognize that they may be in perimenopause and that treatment is available.
Alternative Or Herbal Therapies
- These may include herbal or plant supplements and have been marketed as skin creams and foods with the key ingredient being phytoestrogens.
- Little solid scientific evidence exists to support claims for alternative therapy benefiting menopausal health.
- Black Cohosh has been shown in some trials to reduce hot flushes in peri-menopausal women3. However there have been reports of liver damage with its use which is likely to be due to contaminants in certain products.
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If Your Menopause Depression Is Severe Consult Your Doctor
If you suffer from severe perimenopause anger issues and menopause depression, consult your doctor and discuss all the symptoms and how they are affecting your life. Mention all key personal information. Your doctor can advise or provide the right treatment therapy. Make sure to discuss the medications offered by your doctor, their benefits and side effects before taking the final call.
Transitioning into middle age often brings increased fear, tension, and anxiety. This is often attributed to hormonal changes, such as alleviating levels of estrogen and progesterone. Disturbed sleep, irritability, hot flashes, fatigue sweating, and other menopausal symptoms may cause disruptions. For some women, menopause may prove to be a time of frustration and isolation. People around may fail to understand what psychological and physical changes what youre going through. Women who are unable to cope up with such a situation end up developing anxiety or depression.
The good news is that depression during perimenopause and menopause is a treatable condition. It is important to remember that there are multiple treatment options available that may help to relieve symptoms and provide strategies for coping with changes. Consult your doctor to discuss what treatment options may be the most effective.