Pregnant and struggling without antidepressants

[PregnantAndDepressed]

I'm nearly 12 weeks pregnant and have suffered with depression in and off for about 8 years. I had been on Prozac this time for about a year and it was helping- only 20mg but I was planning on trying to get an increase in dosage as I felt I very much needed it.

Anyway, I am now (unexpectedly!) pregnant and have come off the meds due to fear of causing harm to the baby. My doctor admitted she wasn't an expert in this field at all and didn't really give me much guidance.

Anyway several weeks along and I am struggling. Does anyone have any experience/knowledge of my options and how antidepressants could affect pregnancy?

[Trooperslane]

I was on citalopram the whole time and breastfed for 8 months - you can definitely take something if you want and need to.

Get your midwife on board if your doc is no good - they will be able to speak to the peri mental health team (?) and they see people like this all the time.

Good luck, don't suffer un necessarily.

[Whatdoidohelp]

How did you come off them? Wean or cold turkey? Your GP really should have referred you to a specialist in perinatal mental health. Now you are passed the first trimester you should see about going back on them especially if you are struggling.

[PregnantAndDepressed]

thank you both

My GP said cold turkey was ok due to Prozac lingering in the system. I'm not entirely sure about that though!

At my check in I spoke to my midwife who said to make sure I see GP again if struggling, or to try counselling (not something I feel would benefit me personally)

Trooper that's good to know. I wonder if citalopram is bedt for pregnancy? I have tried that previously but had some side effects which I could cope with if needed.

I have tried googling if there is less risk after the first trimester but can not find anything helpful.

[NanFlanders]

I took Sertraline all through my 2nd pregnancy (much happier than 1st). It's also fine for breastfeeding. Good luck x

[Trooperslane]

Again, no expert but I know lots of people on ADs plus my neighbour is a psychiatrist and I've never heard cold turkey being a good idea.

A few of them are off medication now, don't think anyone went cold turkey.

I'd get midwife on board, deffo.

Ps I was/am on 20mg, lowest effective dose. Did have side effects, though nowhere near as bad as the anxiety I was on them for in the first place.

You won't feel like doing it, but push and push them X

[SnowCurl]

Hi Pregnant and depressed

I started taking Sertraline during my third trimester. And breastfed for 6 months afterwards. Never had antenatal depression prior to last pregnancy (3rd baby) and kept putting medication off hoping it would get better. It didn't. I say that not to make you feel disheartened, but to let you know you are not alone and it can happen to anyone at any time.
I would think if you have had previous history of depression cold Turkey is not the best option. I would suggest you go back to the GP and see if any GP in your practice has a special interest in mental health issues. They may be in a better position to advise. If not ask if you can be referred to the Peri Natal mental health service. My medication was prescribed by a psychiatrist. Due to their speciality, they are more insightful as to current research and drugs. Hope that helps

Xxx

[FellOutOfBedTwice]

First pregnancy On the advice of a shit GP I went cold turkey from Prozac and crashed and burned at about 25 weeks with severe anxiety. I was awake for three days straight, palpitations, the lot. Saw another GP at the practice who said I should never have been given that advice and put me on sertraline immediately. I stayed on it and went back on Prozac after DD was born.

This time I insisted I wanted to say on Prozac. Under care of GP and midwife I lowered my dosage til 12 weeks and have then gone back on 20mg. I was naive last time. I need it to control my anxiety. There are many options. Do not go cold turkey.

[PregnantAndDepressed]

Thanks so much everyone, it really helps to know I am not alone.

I saw my doctor at nearly 5 weeks so have been off the prozac for 7 weeks now and I am really slipping so much. I've had a look at my doctors website where it states the doctors areas of expertise and none are mental health, or even women's health. I will try another GP though and see what they say.

I had already planned to ask if I could go back on them as soon as I've given birth due to how I felt last time. I'm back to feeling like I'm in a black hole and fantasising about walking out into the sea. I won't be doing this, or anything else to harm myself but the feelings are there. But I also know I would spend my pregnancy being so anxious that I was causing harm by taking something and convincing myself something was wrong.

A bit of a double edged sword, isn't it!

[PacificDogwod]

Have you been booked with a midwife/hospital yet?
Please tell your MW how you are feeling.

Many women continue taking ADs during and after pregnancy, Sertraline is seen as the preferred choice because of its short half-life and it can also continue during BFing, but other SSRI such as Fluoxetine and Citalopram can also be taken.
There are small increases in possible effect on the developing fetus in the first trimester and possible withdrawal once the baby is born, but these risks need to be balanced against the risk of an ill mother, so please seek some RL help.

Antenatal depression is not as uncommon as you'd might think, particularly when you've been depressed before you even became pregnant.
Many areas now have perinatal mental health teams - I am a GP and happy to advise a pregnant woman of her choices wrt to ADs, but would also seek the advice of a specialist service.

[PregnantAndDepressed]

Thank you Pacific, I will be making an appointment with a different doctor Monday. I will be 12 weeks tomorrow so it is reassuring to know that the effects are less after after the first trimester.

Has anyone found therapy to help? I have never tried as I felt it wouldn't be helpful to me- clinical depression and anxiety is prevalent particulary amongst the women in my family and I feel it is just something that is 'there' with me. Sometimes it is kept below the surface then it will rear it's ugly head seemingly for no reason. I recognise the signs then trot back to the doctors.

I don't feel I have been managing it particularly well!

[doricgirl]

Hi there

If you're in England there is a bit of a push to make sure there is perinatal MH access for all women. I found even with a severe history of mental health problems I had to push the midwife to refer me to the specialist MH midwife but it has been invaluable as I have struggled during the pregnancy.

I reduced my medication - sertraline - but didn't come off and now I am going back up but am being supported by specialist midwife with oversight from a perinatal psychiatrist. You could try calling the midwife's office and asking if they have a mental health specialist who you can be referred to. Also I have been told if I am really struggling and distressed I can go to the antenatal assessment unit - this is a bit later on as I am 7 months but I have done this and they were amazing.

I hope you get the support you need - I know it's incredibly hard when you feel like shit but keep pushing. Counselling can be really helpful just to feel you have somewhere to put the difficult thoughts and contain them.

I also work in this sector and if you're willing to say roughly which region/health board you're in I could look for what's in your area.

[PregnantAndDepressed]

Thanks so much Doric that's really helpful. I'm in Staffordshire.

[doricgirl]

Hey

This is what I have come up with:

www.brighter-futures.org.uk/mental_health/scheme/helpline
This looks like the best bet for finding out about support in the area

Plus these are specific services which might help:
nsmind.org.uk/how-we-can-help/how-we-can-helpadult-counselling-service/
www.changes.org.uk/index.html
www.pandasfoundation.org.uk/how-we-can-help/support-groups/join-a-group/reach-pandas-support-group.html#.VtDf4Obrngk

You could also call the antenatal clinic and ask to speak to the supervisor of midwives about what's available.

I also saw an obstetrician before conceiving and she said that the top priority is for the mum to be well and that depending on the medication it is OK to take ADs in pregnancy.

These might be useful links as well:
www.rcpsych.ac.uk/healthadvice/problemsdisorders/mentalhealthinpregnancy.aspx
www.tommys.org/pregnancy/your-life/mental-health

Take care :)

[PregnantAndDepressed]

Thank you so much, I will have a read through those links now

[SnowCurl]

I completely agree with the other comments about the importance of any baby/child having a healthy mother. I can only speak for myself here, but I reached a point where it was no longer tangible for me to continue without taking medication. I discussed the risks extensively with the psychiatrist and on balance, I had to try and ensure that I was in the best possible state to look after my two existing children and the one that was to come. I was put on the lowest therapeutic dose (25mg), half the normal dose. I met regularly with the psychiatrist, community mental health nurse and also began Cognitive Behavioural Therapy, which I found to be indispensable. There is help out there. Sometimes you do have to be forthright and push for it. Ironic really considering that when you are depressed these things are in fact very difficult to do.
Big hugs to all who have posted here. It is nice to see such support. Xxx