To not take antidepressants for postnatal depression?

(42 Posts)
Slushysnowmush Fri 25-Jan-13 16:27:53

I have been diagnosed with PND (have two children, 6 months and 3 yrs old) and have been prescribed anti depressants (Sertraline). I am breastfeeding and the doctor couldn't assure me the drugs would be absolutely safe - only that the 'benefits outweigh the risks'. She also told me to watch out for any strange behaviour in my baby shock

I am trying to get better without them but am finding it a struggle. I often think I am a terrible mother and that my children might even be better off without me, although most of the time I know this isn't true. I get by day to day but find socialising difficult - even though I know this is what I need!

AIBU to not take the drugs?

Crawling Fri 25-Jan-13 16:32:02

Paroxetine has no known side effects in breastfeeding. Its considered very safe it is hard to get off though.

TickleMyTitsTillFriday Fri 25-Jan-13 16:33:46

I would take them and stop breastfeeding. I think that its much more important that you get well.

I hope that your Dr also organised counselling for you?

Good luck, I am on 100mg sertraline and am just starting to feel normal again, it's made me realise how ill I was.

You are NOT a terrible mother! Thats the pnd talking.

MsVestibule Fri 25-Jan-13 16:35:50

This is a very personal decision, and I would imagine all most MNers can do is give you the benefit of their experience. I started taking Prozac when DS2 was 7 months, and it helped enormously, but I'd stopped breastfeeding by then.

I would hazard a guess that your GP isn't allowed to give you a cast iron guarantee that any drugs are perfectly safe.

If you choose not to take them, what will you do to help you recover instead?

Crawling Fri 25-Jan-13 16:38:03

But YANBU for not taking them if your nervous I have scizoaffective (mix bipolar 1 and scizophrenia) and I held of meds as long as possible while bf. If it makes you feel better I now take two anti depressants and a anti pyschotic while feeding with no ill effects to my baby.

ReallyTired Fri 25-Jan-13 16:38:54

I am sorry you are ill. Your fears about medication are understandable. The only problem with not taking medication is that depression can worsen. Would it be worth seeing your GP/ health visitor every couple of months or so to watch for signs that depression is getting worse. I chose not to take anti depressants and I ended up with a nervous breakdown, however my experience is extremely rare.

Sertraline has been taken by lots of breastfeeding mothers and it is considered to be extremely safe. I don't know of anyone who has taken sertaline and whose baby has experienced side affects.

Have you got any pychological support. (Ie. what is your health visitor like?)

I suggest you try this website. It's free so you have nothing to lose if CBT does not suit you.

IneedAsockamnesty Fri 25-Jan-13 16:40:15

It would be stupid not to. Stertraline is a ssri these help with your levels of serotonin and is not usually prescribed for mild depression it tends to be used in sever cases.

Whilst in pregnancy its not a good idea due to foetal abnormalities in animal tests after (12 weeks its a class c) bf is a different matter

Less than a third of the product passes into your milk and even less shows up on tests in the baby in most no trace is detected.

Has your docter told you why they have picked that one?

bonzo77 Fri 25-Jan-13 16:41:14

It's hard for me to say as I FF. I think you are amazing to have BF for 6 months. But I've started sertraline in the last few weeks and feel so much better. Your baby had had a huge benefit from 6 months BF. FF is a perfectly adequate substitute and maybe you need to look after yourself too now.

ChocolateCoins Fri 25-Jan-13 16:44:12

I'm not in anyway saying you shouldn't take the ADs but this is my experience. I had PND after DD was born and didn't take the medication offered to me because I was breastfeeding and didn't want to take anything that might harm DD. It took me a long time to get over the PND. I still don't feel I'm fully over it really. And I found it a huge struggle some days, but I did eventually start feeling better, it just took a long time. So to me, YANBU to not want to take them.

Zzzzmarchhare Fri 25-Jan-13 16:46:29

Have they offered you any other type of treatment? Counselling? Local support group?

If you want proper advice about breastfeeding on sertaline you can phone your local hospital- ask for pharmacy and medicines information.

I resisted taking antidepressants and a support group helped bit when that finished I sank badly and needed antidepressants.

ReallyTired Fri 25-Jan-13 16:46:57

I feel that describing someone's decision not to take anti depresants while breastfeeding as stupid is most disrepectful and unhelpful to the OP. Giving up breastfeeding when you don't want is emotionally very difficult. If the OP wants to continue breastfeeding then she might benefit from contacting La Leche League.

There are ways of boosting your sertatonin levels naturally. For example eating turkey and omega 3 oil capules can help your body manufacture sertatonin naturally. Or you can take St John's Wart.

StripiestSocks Fri 25-Jan-13 16:48:21

Im sorry you are in this difficult situation. Has your doctor arranged counselling? As you have a young baby you are a priority case.

YANBU to find it hard to decide, this is a difficult situation all round. Would you describe the doctor as a good doctor, sympathetic, thoughtful? If yes return to talk the options through. If not, find a better GP and talk it through. and ask for counselling!

LaQueen Fri 25-Jan-13 16:49:21

So nsorry you have PND.

I was diagnosed with it, after I had DD1 and was prescribed Sertraline because I was BF-ding and also very quickly pregnant with DD2. I quickly stopped BF-ding DD1 at about 6 weeks anyway.

The sertraline helped, it really helped. I felt calmer and more able to cope. It improved my sleep quality, too. Basically it just took the edge off. After I'd been taking it for about 4 weeks I can remember actually feeling like I wanted to cuddle DD1, and not just going through the motions.

And, I really think it was far more beneficial for DD1 to have a Mum who could warm towards her and engage with her, and be (fairly) upbeat - than it was to have a Mum who was so low and withdrawn and anxious, but still BF-ding her.

After I had DD2, my GP mistakenly changed me onto Prozac, saying it was better/newer than Sertraline. I hated Prozac, it set me back months and just made me feel like an android.

StripiestSocks Fri 25-Jan-13 16:49:30

Be cautious of st john's wort while breast feeding surely? Not a mild drug. Surely need advice on this option.

MrsWolowitz Fri 25-Jan-13 16:51:54

I'd take the tablets and stop BF.

I'm on ADs orignially for ND and I have now been diagnosed with bipolar.

You are NOT a bad mother for having PND.

I will say that bipolar doesn't make me a bad mother but I'm a better mother when I've taken my tablets. It does make a massive difference to my, and subsequently my DHs and DC's, quality of life. Thats just my opinion but certainlt take the tablets.

Hope you feel better soon.

MsVestibule Fri 25-Jan-13 16:52:23

I agree with Bonzo77. Your baby had had the benefit of 6 months breastmilk, and perhaps if you are so concerned (understandably) about the potential effect on your baby, would FF be an option for you now?

Of course the benefits of BF are well known, but your mental health is important for you and your family too, so perhaps that's something else to weigh up - is improving that more important than continuing to BF?

newgirl Fri 25-Jan-13 16:54:13

there are ways to help some depressions such as exercise, getting plenty of sleep, eating really well, spending time with positive friends etc but none of these are easy as a new mum or when you are depressed! If you feel you can manage all these things you may be able to manage without medication but none of us know how serious things are for you, so the medication might be the best thing to do.

Why not put yourself first and get well - the whole family benefits honestly.

Message withdrawn at poster's request.

fifitrixibell Fri 25-Jan-13 17:02:23

Hi - I'm so sorry you are struggling with PND. I ahd it after all of mine and it was particularly bad after my 3rd. I had been on Prozac, but was taken off it towards the end of my pregnancy because it is known to have effects on breast fed babies. I then nosed dived when DS was 6 weeks old, and was started on sertraline, which is considered safer for breast feeding. I carried on feeding him till he was over a year old, and didn't have any problems with it at all. I just realised that if I didn't take the medication I couldn't function, and couldn't care for my children properly (and had suicidal thoughts) so for me, medication was the best thing. I hope this helps, and I hope you feel better soon.

SirBoobAlot Fri 25-Jan-13 17:15:13

There are lots of safe anti depressants you can take whilst breastfeeding, of which Sertraline is one. Contact the breastfeeding network drugs line, they're superb.

Many many mothers breastfeeding and take various medications, so although your anxiety is understandable, I think your doctor went a bit OTT with his warning!

valiumredhead Fri 25-Jan-13 17:15:40

Sorry you have PND OP, have you been offered counselling?

crawling I came off it by talikg a liquid form and cutting back a tiny amount every month or so - took about 8 months or so to get off it completely.

IneedAsockamnesty Fri 25-Jan-13 17:17:18

Really tired, its an figure of speech not a insult. I also said nothing about giving up breast feeding.

For a medication that has been in use for over 20 years and has been decreed as ok to prescribe to breast feeding mums with no need to stop bf due to it not being detected in the baby's platelets,stopping if you did not want to would not be needed.

Its normally used for sever depression, one would think if the prescribing docter has assessed the suituation correctly that treatment is needed,in a ideal world that would be a combo of supportive therapy as well as medication when warrented.

uberalice Fri 25-Jan-13 17:19:13

I was prescribed Lofepramine when I was BF. The doc assured me it was safe.

LaQueen Fri 25-Jan-13 17:29:40

I didn't think Sertraline was prescribed for severe depression? I don't think mine was that bad? I do know it is also prescribed for effective pain relief, too.

Jambonfrites Fri 25-Jan-13 18:31:17

OP, lots of sympathy. PND is vile. I wished I was dead every minute of every day for several months after births of DCs 1 & 2. Finally a health visitor persuaded me I did need antidepressants (which I had rejected for ages because of the breastfeeding situation). I took sertraline and it has turned my life around, honestly. It has made me feel rational and calm and able to cope. When DC3 was born last year I went back in sertraline very soon after the birth and I am exclusively BF. I know this isn't scientific but all my kids seem like fine, happy, normally developed kids. No weird behaviour!

Good luck with whatever you choose to do.

Crawling Fri 25-Jan-13 18:34:05

Thanks valiumredhead I take it but my pyschiatrist seems to think I will always take it but I may get to come off so thank you.

stopgap Fri 25-Jan-13 18:38:39

Has your GP checked your thyroid? I thought PND had struck when my DS was nine months, but turns out I had undiagnosed postpartum thyroiditis. Fatigue, depression and irritability are just some of the symptoms. I now take replacement thyroid and feel like my old self again.

Schmoozer Fri 25-Jan-13 18:41:48

I would advise take AD as prescribed,
Dont go down the st johns wort route
Too complicated re drug dose etc...
Have your ADs and mood response properly monitored by gp,
There is a lot of evidence that depressed parents affect development of children,
IM not saying that is / will be the case with your kids,
More that it is something to consider if you decide to leave depression untreated,
Most people feel pretty yuck when they first start ADs but this usually quickly subsides within a week, ten days, so definately worth sticking with it, and people generally start to feel more like their usual pre depressed self after 2 weeks, if not, may be that a higher dose is required,
Best wishes op

Pontouf Fri 25-Jan-13 18:47:03

Obviously as MsVestibule said up thread, I can only tell you my experience. I was diagnosed with PND when my DS was 8 weeks old. I was quite anxious about taking ADs but was feeling extremely low and was very worried about the fact that I really wasn't bonding with DS. I was also breast feeding. I was prescribed Citalopram which made a massive difference to me and my relationship with DS.

I breastfed until he was 6 months old and had to stop because I went on some medication for sciatica which could not be taken while BFing. I had struggled hugely to breast feed and was heart broken to give it up, as I'm sure you can appreciate. However I decided that as DS had had 6 months of breast milk and was thriving, it was more important that I wasn't crying in pain everyday and weened him off the boob so I could start the meds.

It wasn't an easy decision and I don't think yours is either. I do think it is important for children to have a mentally well mother who is able I function and if the best way to achieve this is ADs then I would do it. Difficult to know though without knowing more about your situation. Do you have a partner? What do they think?

domesticslattern Fri 25-Jan-13 18:56:45

Like others, I can only tell you my experience. I went quite quite bonkers with PND after DD1, and my HV and GP both wanted me to take ADs but I refused because I was bf.

In hindsight, I was not in a good position to make a clear judgement. I weighed up the benefits of bf versus the benefits of my own mental health, and decided bf was more important. TBH I had zero perspective or insight into the situation, I was just concentrating hard on getting through each hour. I thought I was putting my baby first, when now I would say that it is putting baby first to give her a mother who- not to put too fine a point on it- can function. Can smile. Can laugh. Can meet her friends. Can exercise. Can cook proper meals. Can interact with baby in a natural and enjoyable way. I couldn't do any of these things very well. sad What a waste of two years. It is only now I have DD2 and no PND (thank god!) that I can see this.

It is not an easy decision, but there's my anecdote for you.

butterflyexperience Fri 25-Jan-13 19:08:27

Why are some posters recommending op who has pnd to simply take supplements and exercise???

There are many cases where people NEED prescribed medication because they are ILL!

It is not just in their heads where a little sunlight can cure it.

Op please ignore such ignorance.

MrsWolowitzerables Fri 25-Jan-13 19:17:33

Butterfly I completely agree. Exercise and diet etc are very important but the doctor has diagnosed depression and has prescribed tablets so the medical advice should be followed.

I recently had someone tell me my bipolar was due to full moons. I was very hmm and felt like shouting "Do I look like a fucking werewolf?" She meant no harm but its just ignorance.

ImAlpharius Fri 25-Jan-13 19:17:38

Another anecdotal but I take sertraline and have done (in varying doses) while bfing all three DC. The only time I have stopped is while pregnant.

The only effect I noticed is when I upped a dosage they seemed sleepy when I did.

With my first I was very nervousand not sure about taking it, the consultant who turned up at my house didn't give me a lot of options. I did phone NCT and looked at the Kellymom website and looked at studies, it gave me a lot of reassurance.

LaQueen Fri 25-Jan-13 19:52:28

I'm very hmm about advocating plenty of sunshine and fresh air for PND.

PND is a nasty, bastard illness which if you have it, really isn't going to drift away after a few bracing walks and a bit of yoga. And, if it does then I would hesitate to think you truly had PND...and instead, were probably just struggling with the normal stresses of coping with a newborn, that everyone gets.

I am generally considered pure nails by friends and DH, nothing phases me - I buired my Dad on the same day my house burned down, and still rose the next day wearing lipstick and a fixed smile.

But PND floored me in a way that was simply terrifying. I was virtually incapable of even getting myself showered and dressed in the morning and seeing to DD1's needs. I just used to tip everything I needed into a huge bag, drive to my Mum's then get myself and DD1 ready there, with her help.

Some of my thoughts were frankly irrational, my memory turned to mush, I cried myself to sleep every night and every day I woke up with a racing heart and shaking hands.

No matter of sunshine and cheery company was going to cure me. Nothing.

Hi OP, I haven't read all other posters but I know exactly how you feel, I didn't want to take sertraline either when BF, because i thought it might harm DD, I have 2 children and with my first I tried every other option first - acupuncture, counselling ... I ended up in a situation where I was even more depressed. So I went onto the sertraline having spoken to a special Drugs in BF helpline (don't know the no now sorry) who said would be fine, and my Dd was fine, I bf DD until she was 18 months. I realised at 6 weeks post DS birth that I had it again and went straight onto sertraline, went up to max dose 200mg and had no effect on DS. I'm still feeding DS now at 22 months and am weaning myself off the sertraline.

It is entirely up to you of course but FWIW I don't think you should stop BF. Your baby is 6 months now which will mean you are feeding far less and they are that bit more strong and more able to take the minuscule amount of sertraline should it get through - better 6 months than 6 weeks eh?

I hope you get through it anyway, huge sympathy because its a hellish time. Please PM me if you want to talk further xx

IamnotaStepfordHousewife Fri 25-Jan-13 20:18:24

I had to take ads whilst breastfeeding, the percentage that passes through milk is tiny, we looked into it. It did not effect my ds in any way. Obviously its your choice but from my experience I would say it does help. Pm me if you want too x

ReallyTired Fri 25-Jan-13 20:26:02

The OP does not want to take anti depressants. Unless she is sectioned then no one can force her to take medication. We have no way of knowing how ill the OP is, only her GP knows. If the OP does not feel confident in her GP's judgement then she can ask a different GP for a second opinon.

If the OP is really admant that she doesn't want medication, then I was only trying to suggest other possible ideas. Certainly for mild depression self help books, websites, exercise, diet can help up to a point. If the OP has mild depression then its possible to stop in its tracks without medication. What is vital is to prevent mild depression developing into something really nasty.

Medication literally can be a livesaver, but people get better quicker if they have a combination of medication and pychological intervention. If someone is severely ill then medication is essential.

I would suggest the OP contacts her local mind network as they often run useful courses to help people with mental illness.

Crawling Fri 25-Jan-13 20:44:29

I agree with reallytired the things she named are proven to help depression ob they are not as good as meds but if op wont take medication they are better than nothing.

SirBoobAlot Fri 25-Jan-13 20:48:51

Op, by the way, there is also a book called ''Medication and Mothers's Milk'' which is all about the levels of all different medications within breast milk. Your doctor should have one, and you are allowed to ask to have a look at it if it would reassure you. Do contact the drugs line I posted above though as well, just thought that maybe seeing it in black and white in a book might set your mind at rest a little.

mrlazysfishwife Fri 25-Jan-13 20:55:08

Another one here taking setraline and still bf. I researched it and spoke to others in my situation before I made the decision. Ds is fine ( he's 15m now). I knew that I needed the AD's, but for me I also would have felt terribly guilty if I'd stopped bf ( that is a very personal issue of mine).

You need to do what's right for you. But setraline is seen as safe, be assured.

pomdereplay Fri 25-Jan-13 21:03:59

Another here who has PND and is breastfeeding.

My GP liased with a paediatric specialist to put my mind at ease about taking Sertraline. My DD is 11 months, I have been on Sertraline 100mg for over 6 months now and exclusively BF. My daughter is tremendously healthy and (if I say so myself wink) super bright and thriving. Maintaining the breastfeeding relationship has, in conjunction with careful medication, really helped me over the worst of postnatal depression.

It is an awful illness. I urge you to reconsider using medication; before I sought out treatment, I thought I would never 'properly' love my baby or find anything to enjoy about parenthood. Now my DD is approaching her first birthday and I couldn't feel more differently. Good luck and I hope you find your way to feeling better soon.

Slushysnowmush Fri 25-Jan-13 22:28:54

Thank you so much to each and every person who has taken the time to reply. All the posts have given me lots of food for thought.

I still haven't made my mind up, but I do feel reassured knowing others have taken the medication and BF. I have just started counselling, and am trying everything I can to feel better. Sometimes it seems to be working, other times I feel I need more help.

Thank you all again, it really means a lot to me to read what you've written.

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