Consultant prescribing ADs without even seeing me? (Pregnant)

[LongTailedTit]

Just wanting to gather a few opinions if I may?

Backstory:
After the slightly early birth of DS (now 2.5) I developed PND, which wasn't officially diagnosed until he was 1.5, as I have had periods of depression since childhood and therefore can fake happy/ok quite convincingly (to my detriment on this occasion).
I was still BFing, so my v lovely GP decided with me that short course of Paroxetine was the best route - took it for six months, slowly stopping in the early months of this year.

After quite a few months off the ADs and sure I was feeling fine, DH and I decided to TTC DC2, and I'm now 18wks pregnant.
Recently I've recognised the same feelings of panic and desperation that were around at patches of my PND, and had a bit of a freak out last Sunday, throwing stuff around, crying for hours on end, felt completely desolate, saying things like I didn't want the baby or to be with DH (neither true but felt it at the time).
This has built up over the last few weeks, and the only reason I let it out on Sunday was that DH was home so I knew DS was sorted. I haven't had such a dramatic meltdown ever when in sole charge if DS and really doubt I would.

I went to see my GP on Tuesday, to discuss it with her. She said that if I weren't pg, she would recommend I go back on the ADs, but that as I was she would refer me to the psychiatrist at the Hospital, for an appointment to discuss it further and see what the best course of action was.

So - i finally get to the point - On Friday I get a call from the Hosp, saying "Right, the consultant has decided that you should immediately start a course of Sertraline, the prescription will be available at your GPs this afternoon. We will make an appointment to see you in two or three weeks time."

WTF?!! Diagnosing over the phone now, are we??! I was a bit stunned.

I said to the chap that I was supposed to see someone, he was completely thrown, and just kept repeating that I should start the medication as that was the consultant's decision.

I then had a follow up call from an admin lady to book my appointment in 2-3 weeks, "due to the change to your medication". I explained against that it wasn't a 'change', it was a brand new course of treatment that hasn't even been discussed with me or might not even be necessary, and she too was confused, but I booked in anyway as she pointed out I could cancel if nec.

My GP called today as she's had a letter through saying that they had seen me in clinic (!!) and all was sorted.
I explained the weird calls, she was a bit shocked, and felt their letter was misleading and is going to investigate and get back to me.
I also said I've felt fine ever since last Sunday, and am not at all convinced that meds are necessary.

TBH, I haven't felt out of control once in the week since my meltdown, and I'm starting to wonder if it was all just some huge hormonal pregnant blip.
I've talked to lots of friends about it, and DH of course, and everyone thinks that leaping onto meds without even talking it out properly with a HCP is more than a bit daft.
Most of my panicky desperate moments are prompted by DSs behaviour (he screams a lot and has to be watched like a hawk as he bites/claws at other toddlers), and tbh, I feel I'd be better off learning to cope better with him.

Obv Sertraline is meant to be safe in pregnancy, and I know friends who've taken ADs in pg, but surely it's not something you do unless you and your GP are absolutely certain it's necessary? And not just because a GP has sent you a referral and you can't be arsed to see the patient until ADs have already kicked in?

for reading!

[LongTailedTit]

Oh bloody hell that's long - sorry! Must learn to be concise...

[BetterWithCheese]

I'm guessing that consultant assumed you and GP had decided ADs were what you needed/wanted and you were just looking for advice on which ones to prescribe. It'll depend on what your GP put in the referral. Not sure why letter back said you were seen when you weren't

[LongTailedTit]

Yes, I was wondering what she put in the letter, that they'd decided they didn't even need to see me! But at the appointment with her, we both agreed it would be better for me to see someone and discuss options etc.
I had 6 weeks of CBT last time as well that were slightly helpful, so assumed there was an alternative to just going straight onto pills this time.

[LongTailedTit]

Just to follow up -

My GP sent a rather shitty letter to the consultant, saying she how cross she was about their handling of the patient and the letter that lied about seeing me.

She got a very grovelling one back, apologising, but also saying they assumed she just had wanted confirmation of medication choice for a reluctant patient.
This was not what her original referral had asked for - she had said clearly that she was happy to prescribe if nec but wasn't sure it was the right course of action and so wanted me to be seen and assessed by them.

Anyway - this is all weeks ago now, I saw her this week for a follow-up appt, during which we decided it wasn't antenatal depression at the mo, but that I would see her around 36wks, and again after the birth if I felt anything less than on top of the world.
I have agreed that Sertraline would be a good choice if I'm heading down PND avenue again.

All fine for the moment tho! :)