To go back on ADs after working SO hard to wean

[HopsNim]

Sure this topic has been done but in need of urgent help and opinions. I have weaned off sertraline (on for 5y after PND) to TTC no2.

Did sensibly. Tapered slowly. Added exercise and lots of distractions. Booked counselling and planned coping strategies. Was going well for a month or so but boom, here I am again. Not so much depressed as wired, anxious, obsessive and thoughts racing - same as before.


am unable to function without feeling trapped by extreme fear and panic attacks everywhere I go. I'm ruminating on the strangest questions (last week about how well/poorly I treated my pets when I was a child, three days of my life given over to that in fact - I NEEDED an answer - literally couldn't talk to anyone while I figured it out) and it's pretty scary. It's like I'm seeing life with crazy goggles on right now.

This has taken me by surprise as haven't been depressed for a long time (Hmm that'll be the ADs) and kind of thought maybe I was better for good. My MH team have now told me my depression is down to quite a severe chemical imbalance that possibly followed or was triggered by pregnancy no1 and I'm likely to always need medication.

I KNOW I'm much much better, close to normal even, on the drugs but I hate the idea of knowing I'm starting my pregnancy - should I be lucky to fall pregnant - with an added risk factor (to my advanced age, very slight overweight size and previous complicated delivery).

Not having dc2 is not an option - ive put it off for 5 years following last PND and I'm getting on. I really don't think I could look back and feel we didn't try to give DS a brother or sister. Really really not an option and breaks my heart when people gently suggest it.

So is it: suck this up till I fall pregnant and have baby then go back on pills to be normal (I know you'll all say that is not an option, I feel it to) or go into pregnancy with added risks (which seem almost intolerable but apparently that is my crazy talking)?

help!

[celtictoast]

Go to the GP to discuss the benefits and risks.

[Bakeoffcake]

Yes please go to your GP.

[HopsNim]

Don't need Gp as have psychiatrist and he says better to be back on them regardless, but will need to accept the risks if TTC, which we've discussed. Ultimately he says is my choice but hoping to get some opinions/personal experience

[Imknackeredzzz]

I came off citalopram whilst TTC worst decision I ever made. I had a breakdown to the extent that I almost lost my job but most importantly got pregnant and almost lost the baby through stress and not being able to eat and drink and look after myself.

My psychiatrist told me for every 2,500 people who take anti depressants whilst pregnant one child will have withdrawal symptoms. And of those most are minor and of the ones that aren't- even those babies recover within 72 hours

It honestly isn't worth the risk- keep taking them and loom after yourself and baby

[HopsNim]

Imknackered I'm sorry to hear that, did you go back on the citalopram during your pregnancy? I'm worried I am headed down that path at the moment (minus the pregnancy), am definitely not looking after myself and have not eaten all day - but I keep telling myself I can sort this out myself if I put my mind to it, trouble is it has been a downward slide for quite a while now.

I'm mostly scared that I'll have a sick baby or one that develops problems later and then I will wonder if it was my fault

[Bakeoffcake]

Hops I wasn't TTC when on Citrolapram, but I had similar withdrawal symptoms as you. I decided that it was much better for me and my family that I took a tablet and that I was happy and stable, than to not take the ADs and be ill.

You say you aren't looking after yourself or feeling ok so I'd say you'd be better off taking the tablets and getting yourself mentally well again x

[VulvaVoom]

Hi OP, I've just been to the docs to talk about my ADS as I'm also ttc. I've cut them by half already (on my own) but I have a fear of not being on them and going downhill but a bigger fear of giving my unborn child a medical problem. It's such a difficult line so I understand where you're coming from but I do feel it's best if the mum is 'well'. The fabulous doc I saw the other day, gave me no guarantees but said the mums mental wellbeing is the priority.

[CurlyCustard]

Make an appointment with your psychiatrist. I was told that sertraline is one of the better ones to be on going though pregnancy (previous discussions with gp regarding ttc). See what he/she suggests. It's far better you take something sooner rather than later. You've done so well on them and you won't have failed for having to go back onto something, I'm now on mirtazapine due to major depressive episodes after dragging myself back to the gp. You CAN do it OP, lots of luck ??

[CurlyCustard]

Not supposed to be question marks stupid phone!

[IceBeing]

Are you getting CBT to help treat the rumination issue? Did something trigger this latest outburst?

[HopsNim]

thanks all for advice and encouragement - agree my wellbeing must be priority, just so scared. I was told my fears are partly my anxiety/OCD but I don't know - I think they are justified, maybe just amplified and a bit too black and white now.

I am having CBT to help with the rumination ice and it was so, so helpful while on sertraline (it was DBT sort of stuff that I was doing plus mindfulness, and it really worked, but no feels totally ineffective since I came off the pills, the thoughts are just too strong). There was no particular trigger, everything is a trigger right now sadly :(

[Imknackeredzzz]

Hi yes I went back on citalopram during the pregnancy, very early stage actually - about 6 weeks in. Had no issues at all - went back to feeling stable again and now have a bouncing healthy 6 month old boy.

The midwives made sure he was watched after birth to make sure there were no problems- it was 100 and 10 percent the right decision.

How could I have looked after a baby, if I couldn't even look after myself

[ProudAS]

Hops you should be discussing this with your GP.

I know first hand how debilitating depression can be and you will be no good to your DC if it is not under control.

[Crabbitface]

I had a period of mental ill health with symptoms almost exactly like yours a while ago. It was triggered by a health scare and a serious hormone imbalance - i was prescribed sertraline. Conceived while on it and only came off about 4 1/2 months into the pregnancy when I was feeling strong enough. Like others my GP advised me that it was the safest AD to be on in pregnancy and that it was far preferable to having my previous symptoms insomnia, obsessive thoughts and zero appetite. My baby was born completely healthy and happy.

Quite often GPs aren't as up to date with medications as they should be - but pharmacists are. It could be worth your while making an appointment to speak in private with a pharmacists just to discuss their opinion on which would be the least risky AD to take during pregnancy.

But I would go back to sertraline for now - your child who is here right now needs you to be healthy. Hope you start feeling better soon.

[sandy30]

I tapered down from 20 to 5mg of Citalopram before becoming pregnant with my healthy DS. Shortly after my son's birth, I was hospitalized with anxiety and PND and went back up to 20mg. I do wonder if I would have become (so) ill if I had remained on 20mg throughout.

My main reason for weaning was actually to BF - my GP was adamant that I couldn't do so on citalopram, which my psychiatrist overturned. I was also concerned the ADs had caused previous miscarriages, but couldn't find much research on this.

There is a small increased risk of health problems in the baby with both uncontrolled depression in the mother and ADs. The risk with ADs is dose-dependent, so could going back on your lowest effective dose be a compromise?

The tapering is hard work, so I feel your pain!

[ASAS]

YADNBU to go back on ADs if you need them. Bit disappointing and I do understand but don't be hard on yourself, it's not as though you've 'stopped working hard' etc.

[ASAS]

Em, just read one of your latest posts and although I truly, truly get that it's not fair in anyway, what would you say to a MNer who said she was ill with say, a UTI, therefore feeling rubbish and not eating etc, but was convinced she just has to 'put her mind to it' and she'll get better.

A little fight, a little resistance is good, it means you're engaged. But please look after yourself.

[IceBeing]

OP it sounds like you are all over the CBT already - one other thought, did you have a traumatic birth/post natal period? Or did you have the lesser known supposedly classic PND?

I was on then off ADs after suffering PND but what has really made a difference is starting to process the trauma around the birth. Not PTSD but post traumatic depression/anxiety.

Anyway I certainly understand we aren't all ending up in the same place for the same reasons - so just a thought.

[IceBeing]

actually adding up 2 and 2 and potentially getting a million...is it possible that it is the TTC or thought of it that is underlying your high levels of anxiety?

If you did still have unprocessed trauma from the first birth/postnatal experience then maybe it could be triggering specifically now?

[HopsNim]

ice that's really interesting, bit of everything I think. And just the way I respond to things. Anxiety has definitely peaked since TTC. Such a mixed bag. I think I'm going to get through weekend anyway and then make a decision hopefully from a considered point of view, though my instinct is to get back on the pills today. Thank you again everyone

[IceBeing]

I am sure your instinct is correct. Best wishes for it and TTC too!

[witsender]

My symptoms were not as severe as yours, but I went back on Citalopram and made the decision that I will be on them for the foreseeable. My brain chemistry is slightly off and needs help to balance, much like I need thyroxin and vit b12. Our bodies are all different, there is no shame in needing medication if doctors etc work with you.