Reader’s Question

Hello, I am 49 years old and am having problems with menopause, hot flashes, night sweats, irritability, not sleeping well, emotional, fatigue, weight gain. When I went to the doctor she seemed to think that Citalopram 20 mg will help me feel better, feel less fatigued, have more energy etc. I’m really not happy with taking an antidepressant; is the doctor correct in giving me this drug? Also I am having liver problems, which I’m seeing a specialist about, and am going through tests right now.

Our Clinical Psychologist’s Reply

Your physician is correct with her selection of an antidepressant — for several reasons. In menopause, the brain has problems with the production of Serotonin, a neurotransmitter that controls and regulates body temperature, appetite, sleep, energy level, etc. The use of various hormones for treatment indirectly influences the levels of Serotonin. In the current treatment of these symptoms, it is recommended to use an antidepressant that directly influences the levels of Serotonin in the brain — thus controlling not only the physical symptoms, but the emotional aspects of menopause — some of which are depression symptoms. While stabilizing Serotonin levels, the medication also stabilizes mood control, reduces irritability, improves sleep, etc.

I’ve written an article that might be helpful entitled The Chemical Imbalance. It’s available on my website at www.drjoecarver.com. It might be able to explain the various neurotransmitters involved in depression, menopause, and anxiety.

If you are also evaluating your liver functioning, be sure to mention your medication to the liver specialist, as some antidepressants influence liver functioning.

While you’re not happy taking an antidepressant, it’s very likely that you’re not happy with a lot of things at this time. That’s the emotional side of menopausse. I think you’ll be surprised how well the medication works. Keep in mind that she will need to find an antidepressant that is a good fit for your metobalism. Thirty-five percent of people switch medications, so don’t be disheartened if you need to use a different one if the Citalopram doesn’t work well or fast enough.

Hope this reply is helpful.