Menopause and Depression
Many women consult their doctor for anxiety and depression which they asssociate with the menopause.
They are generally prescribed anti-depressants. In the past the same age-group would have received tranquillisers. The most widely-used are Amitryptilene and Imipramine (MAOIs) and the SSRIs - Prozac family, Fluoxetine, Paroxetine and Seroxat.
MAOIs
These act by preventing the destruction of chemicals in the brain such as noradrenaline. This helps to make you more relaxed and lifts the mood.
What are the side-effects?
They also affect other systems which use this chemical transmitter so cause a dry mouth, blurred vision and urine retention. There are worries that long-term use (more than six months) of these drugs destroys the body's own ability to do this job, so that intractable depression sets in when patients try to cease taking them.
SSRIs
These act by preventing the re-uptake of a chemical transmittor called serotonin, so that it remains in the circulation and a feeling of relaxed confidence pervades.
What are the side-effects?
These are usually temporary, but can be severe. The main problems are headaches, nausea, loss of appetite and insomnia. These usually subside after two to three weeks but insomnia sometimes persists for longer. There are reports that long-term use (more than six months) produces a sort of 'euphoric despair' which may result in destructive or inappropriate behaviour. There are even cases of suicidal tendencies.
It should be suggested that all anti-depressant use is accompanied by some sort of 'talking therapy' so that real causes of anxiety and depression are not missed. If you are considering using this group of drugs, you should make firm plans with your doctor for time-limits to treatment, and plans for what to do when you cease taking them. This is yet another reason to look at the menopause as an opportunity to review, assess, evaluate and change!
