Question: Hello,
I am a 45 year old menopausal female, in which is under control now with angeliq and prozac, however, I am not sure if I am undiagnosed with adult ADHD. I have taken several online tests that indicate this on a moderate level. My impulstivity level / hyperactivity level is high. I have always been on the go, ( restless) all of my life. In other words, I do not know how to relax, or sit down much. I always feel as if I have to be doing something. I also have a history of hypothyroidism, in which is effectively controlled with synthroid. I have been extremely forgetful since the onset of menopause, but not prior to that, and I also very organized.I do procrastinate often. I need guidance on what to do to really find out if I have it. My 9 year old son has it. Not sure if his father has it. Need some medical guidance on which direction to go.

My current dosage of Angeliq is 0.25mg/0.5mg 1 po qd. Medication started on 7/18/2013; Onset of menopause at age 41; I initially had symptoms of severe mood swings,followed by hot flashes, crying spells for no reason at times, and tried HRT unsucessfully with activella and prempro, therfore I opted not to take anything further at that time. Prior to starting the Angeliq, I was having menopausal rage very frequently, overreacting, and extreme anger / sensitivity. My moods are much better now. I was diagnosed with hypothyroidism in 2003 after a miscarriage, which required a D&C at 9 weeks. I also believe I had postpartum depression in 2004, in which I did not seek help after I delivered my son per C-section. I have been on Synthroid for 10 years and my thyroid levels are therapeutic at this time. Prior to the prozac, several months ago, I tried taking Celexa 5mgpo qd, which worked really good for me, but caused sexual dysfunction. The prozac works ok, but not like Celexa as far as my mood. It accelerates euphoria, and the prozac does not. What antidepressant do you think may work best for me, without side effects such as sexual dysfunction or weight gain that could work well, that would be inexpensive, as I do not have health insurance at this time.

I worked full time 65 to 70+ hours for a year and a half, and changed my status to part time in March working only approximately 30 to35 hours a week. I recently moved out of town in XXXXXXX and just now finished settling in. I am in a wonderful relationship since last December. My partner is ADHD and has been on medication for 16 years and is fine.

On 08/20/2013, I decided to try Prozac 10mg po daily, in which as of today, I no longer have rage, or lasting anger. I sometimes feel a little down; I tried increasing the Prozac to 20mg po qd, but did not tolerate but only one dose. I felt too drugged / drowsy. I still remain a little anxious, as I have been most of my life, but calmer. Sometimes, I am really fatiqued, and I have no motivation as I used to, to perform my usual activities. My Father passed away 2.5 years ago, and I seem to be coping with it ok. I do not get 8 hours of sleep usually a night; maybe 6 or 7. I am a busy body around the house. Sometimes I feel sleepy / drowsy. Perhaps this is the Prozac, or just fatique?. Not sure. Approximately 4.5 years ago, I got divorced and moved. During this transition, I was prescribed Lexapro 10mg po qd. I did not feel depressed; mostly anxious and heartbroken. I could not take it. It made me too groggy, so I took Pristiq 50mg po qd for about 8 months, until my move was complete, and I was settled in my new home, and decided to taper off and stop; I gained 17 pounds.This was in 2008. In 2009, I began taking Adipex 37.5mg po qd on and off for weight control for 4 years. While taking the medication, my stress level was down,I was happier, and felt great psychologically. Recently prior to the Prozac, I was taking this again for weight loss, and it stopped working; Iam not sure why. I couldn't lose the weight as before, which puzzled me. My MD informed me not to take while on Prozac. I am approximately 13 pounds overweight. She also diagnosed me with Fatigue and Post menopausal disorder. I have been compliant with my medications. I have gained 17 pounds since December 2012. I quit smoking after 27 years in March 2013 with sucess.

Your feedback is greatly appreciated.

Do you suspect I have undiagnosed GAD, or might I have ADHD. I would really like to know what you think?. Is prozac the best drug of choice for me?. When you recommended a benzodiazipine, you thought I would benefit taking this while increasing the Prozac. Can you please explain why?. And would I benefit taking something long term?. Also, my Son has ADHD as I mentioned before. Does this necessarily come from the parent always?. Not sure if his Father has it. I need guidance on the proper treatment for myself. Do you also believe I should stay on an anti-depressant lifelong?.

Thank you

Thank you for your prompt response.

Since ADHD is unlikely for me, I suppose I have generalized anxiety disorder?. Do you agree?. Today is the second day on Prozac 20mg, and I feel ok. I did have an anxiety attack last night that lasted at least 3 hours, so thank you on the elaboration. If GAD , shouldn't the prozac alone be effective enough in controlling my depression and anxiety? , or might I need an additional medication in your opinion?. I presume in two weeks the Prozac should eliminate my ruminating thoughts completely?. If it does not, what do you recommend?. I really prefer not to stay on any benzodiazipines.

Thank you for all of your help...
God Bless