Anti-depressents

Hi All, I am over 2 years since diagnosis. I went through chemotherapy, lumpectomy and radiotherapy as my main treatment and as I'm mid-40s I was put into a medical menopause with zoladex during chemo and then started exemestane around the same time as radiotherapy. I am also on zoledronic acid for 3 years.

The sudden menopause was pretty intense especially alongside chemo, but things have significantly settled and I'm doing OK.

At first, I had quite bad anxiety, especially at night and this was helped enormously by acupuncture.

However, I have been feeling a bit low recently, I definitely seem to feel it at this time of year more than I used to. I'm fine, but low mood and anxiety is not something I ever really had before. My hot flushes are manageable at last, but I still get them and more so at night so not sure if continually waking and then not always being able to get back to sleep easily is contributing to altered mood during the day.

I was reading that low dose anti depressants can be very useful for menopause symptoms and I was wondering if anyone had any experience of them. I was particularly looking at paroxotine as it looks to be good for hot flushes and sleep at low doses and also well tolerated in terms of reduced libido and weight gain.

I've always been very upbeat and I am struggling a bit with these mood changes, especially as it affects my motivation to do the things that I usually really enjoy. I just feel like I need a bit of a boost and options are so limited. I don't think I ever would have tried HRT because of family history of breast cancer, but I would have tried various different herbal supplements to alleviate symptoms. I'm just not going to do that as they are generally phytoestrogens and I don't want to risk them after hormone positive BC.

Would welcome any thoughts.