36 weeks pregnant and keep being told to take ADs but very very nervous about it...

[feeno]

Hi

Long story short-I have severe AND and am at risk of a 2nd bout of PND when after birth of new DC in 4 weeks time.

I've been reading conflicting stories/studies about the use if sertraline in the final trimester and I am so confused. I just don't know what to do for the best. I've been prescribed 50mgs for now but I'm so scared of the affects of the exposure to the baby in utero as it does affect brain chemistry.

Anyone out there taken sertraline in third trimester and have kids that turned out fine? I'm so scared of things like development of autism/ADHD/etc being linked to exposure to sertraline in utero.

Please help, I just don't know what to do for the best here. Should I hang on till after birth or compromise on a 25 mg daily dose (to get used to side affects as well)?

[BeyondTheLimitsOfAcceptability]

I took citalopram while pregnant with DS2, after struggling by on nothing with DS1 (had depression antenally with both, but have long term depression anyway). Not the same drug, but the same kind of drug, and it does the same thing :)

He's nearly five months now, and a happy and quite forward (not one to brag, but want you to know that it hasnt affected his development). He's also on the 75th centile and nearly as heavy as his brother!

One thing that my doctor didnt tell me though, SSRIs do not mix well with Pethidine, so you'll have to do without that in labour.

[BeyondTheLimitsOfAcceptability]

Re autism/ADHD, obviously I don't know about his health long term yet, but remember that a link doesnt prove causality :)

[BobblyOrangeGoldGussets]

I had my second pregnancy on Fluoxetine. The PND so bad with the first one, I was either going to plan conception and pregnancy staying on the ADs or stick with having just one child. DS 2 is fine.

[gingerchick]

Had sertraline with both pregnancies and my girls are 2 and 5 and perfectly healthy. Also had pethidine with my 1st labour and had no problems

[MirandaWest]

I took sertraline from 12 weeks pregnant until DD was about 18 months old. She was bf until she was about 11 months.

She's 7 next week and is completely fine. And I was a lot better when she was little than I was with DS when I know I was actually depressed but didn't do anything about it until he was about 9 months old.

[thingamajig]

You are right at the end of your pregnancy, so the baby has done most of its developing and is now just growing. You should have been told this by your doctor. It is very unlikely that the sertraline will affect your baby's brain development because of this, even if it could have anyway. If YOU need the drugs, you must take them, being depressed in pregnancy itself has negative effects on the fetus, and leaves you more susceptible to PND (which is not good for either of you).
Dosewise, I would trust the doctor; some drugs are not effective below a certain threshold, and there is little point in taking any risk if you are not going to see any benefits. Have you taken this before, and what side effects (if any) did you get?
I took citalopram throughout my pregnancy with dd1, and citalopram plus lithium during my pregnancy with the twins. I also breastfed both times- if this is something you want to do it is certainly possible but some ADs are better than others for this - find out before you start on the tablets. All my children are fine, they are 4.5 and 18 months, so I think any brain abnormalities would have surfaced by now.
You can (and should) get advice from you local hospital's pharmacy information service, they will check all the up to date, trustworthy studies and give you a balanced opinion, either access this through your gp or phone the hospital switchboard.

It is a tough one, and the guilt that your actions may affect you child is hard to deal with, especially when you are feeling so low; depression is a bugger for making you beat yourself up. But I would say, take the tablets, for you and your family.

[AlteredState]

At 36 weeks your baby is fully formed and 'simply' getting bigger. At this late stage in pregnancy you would do more harm to the baby by not taking AD and experiencing worse illness after birth than if you took it. Please don't wait to take them.

[MrsJohnMurphy]

It depends on how desperate you feel I think. I'm thinking back to when I had AND, tbh the pure guilt and anxiety I would have felt for the next however many weeks would have put me off taking ad's in the last few weeks.

If you really do feel that you cannot go on in the pregnancy without it, then take it.

If at all you can wait until the baby is born, it may actually help you, you will not be burdened with the whole guilt of taking a drug which you are not sure about.

I know my advice sounds irresponsible, but for me, taking the drug in the last few weeks, whilst still so unsure would have finished me off. You sound very worried about the drug, ad's in pregnancy have been used to good effect, I wouldn't trust any horror stories on the internet.

I sound awful, but I read something about infant herpes once on the internet and became obsessed when I had AND/PND with ds1 despite not actually having the disease, it was a very circular thought pattern and was horrid. Guilt was the main emotion, lashings and lashings of it .

[tabbycat15]

I took 75mg Sertraline all throughout my pregnancy & also 2.5mg of Olanzapine. I tailed off the Sertraline to 50mg at the end of the pregnancy to help with any withdrawal effects when Bethan was born. When you are pregnant the extra blood volume has a diluting effect on the meds so you have to take a slightly higher dose.
Bethan turned out ok. She was a bit sleepy the first few days & slow to feed but has no other problems.
I would take the meds as after the birth there is a huge drop in Progesterone levels & your mood can suddenly drop. Also with the lack of sleep & if you are at risk of PND taking the meds earlier will help them to kick in.

[feeno]

Yes-sleep deprivation definitely affects my mood for the worse-there was and is a definite link between the wobblier days and nights I had little to no sleep. Even before new baby is here I'm suffering from lack of sleep-insomnia due to the depression or pregnancy-I'm not sure, but it doesn't help the DS who is 17 month old is an early waker with inconsistent sleep patterns and my anxiety around his sleep affects my own.
I was going to start off on 25 mg for week or so may just to try and cope with the side affects. Last time I started these meds they were awful and I felt a lot worse for a while. As soon as I feel my body acclimatise to the drug I'll increase the dose to 50mg.

It is so hard to make the right decision. I have a history of depression so it's likely the hormone shift after birth will tip me over the balance as it did last time although I had no depression during the pregnancy then. I had actually been well and off the ADs for about 3 years. Everything went pear shaped once DS was born and the PND was a living nightmare. I was like a zombie or in complete hysterics for a good 6 months or so.

I dont want to suffer that way ever again-I wouldn't wish it on my worst enemy.