HRT/Zoladex causing depression?

[Levi_jazz]

I’ve been on zoladex for 8 months now and started HRT about 3 months ago but I feel like I’m in such a depressive state at the moment which is very unlike me, I constantly feel anxious and so stressed over the most ridiculous things I don’t want to go to the doctors in case it’s just side effects of this medication but I’m literally pushing everyone away from me I’ve dumped my partner for no reason because I just feel I want to be alone all the time and I don’t really no what’s going on with me

[jelleytots10]

Hi i was on Zoladex for 4 months and HRT for the first 3, i had to be weaned off HRT 4 weeks before my operation. Personally i had no side affects other than being really moody and grumpy, i was snapping at my family members over the smallest of things but as soon as i weaned off the HRT i was at my happiest throughout the whole experience. How did you feel before you started taking the HRT? Xx

[HarrietC]

Hi Levi_jazz,

I have been on zoladex for five months now and have been on the HRT for two weeks now. Yes yes yes, I was fine at first no mood swings or anything, thinking to myself this is great no periods no pain. Then I start getting a bit low and started doubting things, like can I do my job properly? do I love my husband? All these things just crept up on me, the anxiety just got slowly worse.

Then bam...I handed in my notice just before Christmas, which was madness when I look back on it, just out of no where I decided I wasn't able to do my job. Just felt like there was soo much pressure and something was going to give and I wasn't willing to lose my husband, so I got rid of the job.

I'm still not right but it's only six months of treatment and mine is almost over. Best of luck with it all and I hope you find a way through it too x

[Levi_jazz in reply to HarrietC]

I’m so sorry to hear that :/ but I really appreciate you commenting because that is exactly what I am like I’m so indecisive and second guessing every decision I also went to quite my job because I just feel so useless and worthless! It’s a relief to know that is the HRT and I will look to speak to my doctor and see if I can come off! Thank you and all the best on your journey through it to xx

[NoEndoInSight]

Hello Levi-jazz

I'm so sorry that you are having such a difficult time at the moment. Apologies that this is going to be a little bit of a long reply, but I hope that it is helpful.

It sounds like you need to contact your GP and prescribing Specialist about how you are feeling as soon as possible.

Zoladex is a "GnRH Analogue/Agonist". This class of drugs works on your “Pituitary/Hypothalamus/Gonadal Axis” to stop your body producing the leutinizing hormone which usually triggers your body's production of oestrogen / progesterone and thereby your monthly cycle. However, your body uses oestrogen and progesterone for many body processes, and among those processes is the regulation of mood. Both hormones, but particularly oestrogen, play a vital role in your brain’s serotonin & dopamine (happy hormone), and melatonin (sleep hormone) level regulation and uptake. Consequently Zoladex’ suppression of your oestrogen and progesterone levels can cause very significant mood changes (including sometimes severe depression and anxiety).

It is because these neurological side effects (as well as others such as reduced bone density) are primarily caused by the hypoestrogenic (oestrogen-deficient) state "GnRH Analogues/Agonists" like Zoladex induce, that many specialists prescribe them along with complementary dose of "add-back" HRT. The HRT is supposed to "add-back" enough oestrogen (& often also progesterone) to ease some of Zoladex’s more unpleasant neurological side effects without reactivating the growth of your Endometriosis. But every women's body is unique and it can take a bit of experimentation to find the right "add-back" HRT dose, so even if you are already being prescribed HRT it is always important to bear in mind that some women need just a low dose of HRT, while others find that their body requires a much higher dose of HRT "add-back”. Different women also find different brands and formulations of HRT work better for them than others. It is all a case of trial and error finding the HRT dose that is right for you. It is also worth bearing in mind that, for some women, “add-back” HRT is not able to fully overcome Zoladex’s impact on their mood, and therefore a decision may need to be made as to whether it might be best to cease treatment.

So you really do need to let your prescribing Specialist and your GP know asap that your mood is dipping and you are feeling so very low. The quicker they can help you find a way to manage this Zoladex side effect the better.

As well as monitoring your treatment more closely from now on, and trying to help you to find the right "add-back" HRT dose for you etc., your prescribing Specialist and GP should also be able to provide you with appropriate and effective emotional support while you are experiencing mood changes while undergoing treatment - perhaps some counselling from a therapist who is familiar with these kind of hormone treatments and their significant impact upon the brain’s ability to regulate mood.

If you feel that your prescribing Specialist and GP (or any other medical professional involved in your care) is not fully up to date with Zoladex’ published safety advice and side effects information, then I recommend that you print out the manufacturer’s “Summary of Product Characteristics” (SmPC) guidance published on Medicines.org.uk both for you to have a read through yourself, but also to show to your prescribing specialist and GP. The SmPC provides far more details regarding Zoladex’s known impact on mood (i.e. depression/anxiety) than the basic Patient Information Leaflet, but you can find both documents here:

medicines.org.uk/emc/produc...

Medicines.org.uk is the official website where the manufacturers of all licensed UK publish their current drug safety information, so this is recognised as a reliable information source by the NHS and its practitioners.

Also, if you find you are still struggling to secure help in dealing with your treatment’s impact on your mood, it can be useful to know that Zoladex is manufactured by AstraZeneca UK. All of the big drug companies have pharmacologists whose job it is to advise prescribing Specialists, GPs and other medical professionals about their products, the potential side effects of those products, and how best to manage those side effects. Although drug manufacturers are not allowed to give this information to patients themselves, if you are struggling to get your prescribing Specialist or GP to take your concerns seriously, you can report your mood side effects directly to AstraZeneca via their “Yellow Flag” system, and they can then offer advice as to how you might be able to get your concerns taken more serious. Their contact details are:

AstraZeneca Medical Information Direct Line

0800 783 0033

Sorry that was such a very, very long reply, but I hope it's a helpful one, and I really hope you get some support and feel better soon. x X x

[Levi_jazz in reply to NoEndoInSight]

Thank you so much for taking the time to reply, this has been so helpful and I’m generally so grateful! It makes sense of why I’m feeling like this and I’m definitely going to challenge my specialist about trying a different one! Xxx

[ccsmith]

Gosh your the same as me. I’ve been on zoladex a year waiting for my hysterectomy and vowel resection. I was on antidepressants before as I reacted badly to the mirena coil and became very low. I’m on HRT too but recently I’m not coping, I’m anxious, depressed and paranoid. Just like you I feel worthless and do at times think very bad thoughts! I increased my antidepressants by an extra 1/2 tab as I couldn’t get off the sofa and was struggling to get my daughter to school. I’ve made a gp appointment for next week but never really considered my HRT to be not strong enough!

Good luck and best wishes xx

[Levi_jazz in reply to ccsmith]

It’s so good to hear I’m not the only one being scatty and irrational haha! It’s so hard because it’s so easy to get yourself in such a rut with the zoladex and HRT, I will contact my doctor but I hope you also get some answers and support because it’s so horrible to go through especially when the medication suppose to make us better! Xx