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Get updates on how your baby develops, your body changes, and what you can expect during each week of your pregnancy by signing up to the Mumsnet Pregnancy Newsletters.

Get updates on how your baby develops, your body changes, and what you can expect during each week of your pregnancy by signing up to the Mumsnet Pregnancy Newsletters.

Pregnancy

Anti-depressants in pregnancy?

15 replies

susurration · 24/02/2015 16:27

This is a cross post- also in ante-natal depression but I would really like as much experience as possible.

I was wondering if anyone had any experience of taking anti-depressants during pregnancy please?

I'm on 40mg escitalopram daily (which is double the recommended dose, but was agreed with my psychiatrist and GP) for chronic depression and anxiety. I've been very ill and only really well since Aug/Nov 2014. I started this med in May 2014. We are currently just starting TTC #1.

I do NOT want to come off my medication. I've done a lot of reading around what is safe in pregnancy and know that SSRI's are not recommended but sertraline is the drug of choice for most psych consultants when pregnant/breastfeeding. I've read up about the possible side effects and feel informed.

I have an appointment with my psych consultant in a fortnight. What should I be expecting? Any advice or experience welcome.

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LostSoulsForever · 25/02/2015 01:10

Sorry, I can't really help but I wanted to say that I suffered ante-natal depression in my last pregnancy and although I wasn't on it for long, I was assured it was entirely safe during pregnancy. I was past 12 weeks though so not sure if that made a difference.
Hope it all goes well & you are given the answer you want.

susurration · 25/02/2015 21:21

Thank you for your reply. It is reassuring to hear that you were told it was fairly safe past 12 weeks.

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anythingbutinsomnia · 25/02/2015 21:51

I've been on fluoxetine all the way through current pregnancy (30 weeks today) and all ok so far. I was on 20mg alternate days during first trimester but had to go up to 20mg daily to cope at 12 weeks. One risk with fluoxetine is heart issues - all looked good at 20 week scan, but that's no guarantee all will be fine (apparently). Low birth weight may also be an issue but as DD was 10lb2oz, I'm not too worried about that. Consultant has recommended I breastfeed for at least a few days after birth to help the baby withdraw from the fluoxetine, but we didn't discuss the longer term implications as I'm not planning on feeding for any longer than I have to (just a personal thing)

susurration · 25/02/2015 22:24

anythingbutinsomnia thanks for sharing. Another poster has also told me they are on Fluoxetine. Were you on it before you got your BFP? I think there is a heart risk with all SSRI and a risk of withdrawal has been associated with one in particular. Its a worry trying to balance my own health with that of a baby in the future and want to go into all this as prepared as possible.

Thanks for sharing your experience with me.

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Gillian1980 · 25/02/2015 23:47

I was on 40mg of citalopram prior to TTC. I reduced down to 10mg but haven't been able to come off fully. My gp was fine with me being on this while pregnant and said that if I became unwell she would increase my dose.

PippaB007 · 26/02/2015 12:15

I was on meds throughout my pregnancies. I was lucky that my pdoc is a woman, with kids, and a special interest in the matter.

I was on 150mg Effexor throughout, and also secondary drugs (Abilify in the first pregnancy, and Epitec in the second). She was quite adamant that the risks of uncontrolled depression (to both the child and mother) are higher than the risks of medication.

She also wasn't particularly perturbed about weaning off meds before giving birth.

My kids weighed 3.8kg and 3.7kg respectively, had high Apgar scores, and had no issues with withdrawals. Happy, healthy babies.

Don't risk your own sanity. you'll need every bit of it later on...

susurration · 26/02/2015 12:29

Gillian and pippa thanks for your replies. I agree that the risk of my mental health being unstable is more of a liability for a baby as I have a history of very intense panic attacks and other worse thoughts :(

pippa its good to hear both of your babies were healthy. Did she wean you down or did you keep your dose at the normal level?

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PippaB007 · 26/02/2015 14:13

I was extremely depressed during my first pregnancy. My secondary medication increased prolactin, and that led to no periods or ovulation. My doctor didn't check meds side effects, and sent me on a wild goose chase of MRP scans etc. I then read the package insert, dropped the meds (without talking to a doctor first), and was pregnant after the first period.

This was great (and planned), but it also left me with a huge problem. I had meds resistant depression, and it was after only the 8th or so secondary drug that my mood had stabilised. I was on that drug for years, and it worked. And then I wasn't, and I was pregnant, so not keen on experimenting. (Add to this vomiting for 9 months, fighting retrenchment, and having to race against time to finish a thesis - which was eventually done 9 days before giving birth.) I tried one drug, and had it increased a few times, but it didn't help much.

I did some weaning towards the end of the pregnancy, but was still on meds when I gave birth. I didn't succeed in breastfeeding, so there was no 'bridging meds', but it didn't make much difference either.

The second time round, things were a lot better. I had sorted out the meds issue fully beforehand, so nothing needed tweaking. I also saw first hand that my daughter was absolutely fine although I took meds during the pregnancy, and took my meds without giving it a second thought. My son came out happy and bouncy. (He was breastfed, but I honestly don't know if that makes a difference).

If you are worried about your mental health, you are probably worried with reason. It is much much better to stay on the meds. You probably know first hand the damage that a depressive episode can do, and how long it takes to fully recover. Having a baby is enough to deal with (even though it is brilliant, and has made me happier than I've ever been). You don't need to struggle with damage inflicted by not taking drugs.

Good luck. It's not an easy journey, but it is absolutely worthwhile.

anythingbutinsomnia · 26/02/2015 19:11

susurration I'd been on fluoxetine for over 3 years when I got my BFP. This was a completely unplanned pregnancy which happened part way through attempting to wean myself off the ADs. That's why I was only on 20mg alternate days, but was already struggling with the lower dose. Not sure how I made it through the first trimester - the relief when I went back up to 20mg daily was huge.
I've been really lucky with a hugely supportive midwife. I hope you're getting all the support you need

YouAreMyRain · 26/02/2015 19:28

I was on sertraline before I got my BFP. I was under a mental health midwife and psychiatrist. My dose got doubled and then tripled by the end of my pregnancy. Baby very healthy and calm.

susurration · 26/02/2015 22:09

Thank you so much for sharing your experiences and empathising. pippa it sounds like you have had quite a rollercoaster journey with the depression. You're right when you say i'm worried with reason. I'm just coming towards two years since my last breakdown, my worst yet, which i've only really been recovering from since last august. I'm obviously not keen to repeat the exercise, especially not with a baby in tow.

anythingbutinsomnia its good to hear you're doing a bit better now you've been able to up your dose again. It is a real concern for me that I might have to reduce or stop my meds for a specific term.

youaremyrain I didn't know there were mental health midwives, this is something I will file away to think about in the future.

I have an appointment with my psychiatrist in a couple of weeks and we have decided to wait till after I have seen him to get going with TTC properly. I think though we're both coming to terms with the fact that it might not be as straightforward for us in terms of natural birthing and breastfeeding if there is a problem with the AD's or withdrawal etc.

Thank you all, its been really good to hear from other people in a similar situation.

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Queenofknickers · 26/02/2015 22:22

I took fluoxetine through both pregnancies and my DSs are fit and well. I know that's just 2 examples but hope it reassures in some way

SilverStars · 26/02/2015 23:16

Hi, some areas have a specialist mental health midwife. So once pregnant your community midwife can refer you to them - some are based in hospitals - and they can support you in addition to usual physical checks with community midwife.

Also I noticed in is oregnancy in my hand held notes they do 2 actual checks on everyone on MH - ie a chance to discuss mood etc which can help identify people who require more support and possible referral for such.

susurration · 27/02/2015 12:39

Thank you. queenofknickers reassuring to hear your sons are both well.

silverstars Thats good that they ask MH type questions, I think that would be a good opportunity for me to bring up any issues and let them know about the MH issues.

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SilverStars · 27/02/2015 17:04

Yes and they ask them to all patients so great for people not in a system etc to get support!

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