Hi, I'm 6 weeks pregnant with my 3rd child. I had been on 20mg citalopram for just over 12 months. I decided to come off it as was advised it was bad for baby. I went down to 10mg for 5 days and felt awful. I am moody, feel sick (mixture of morning sickness too) feel increasingly dizzy everyday. I just want to sleep all the time or just stay in the house. I've asked my boyfriend to move out because I just can't stand him being here. I just feel crap!! I went back to the doc and he advised to come of it completely with a view to start on fluoxetine in 5 days.
Will I feel better again, I felt like this before I started on the citalopram and worse when I started it. But felt fantastic once it had settled down. I'm scared I'm gonna feel like this for ages and its ruining my happiness at being pregnant. I'm just so sad ?
Any advice and reassurance welcome
Thanks
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Pregnancy
Coming off citalopram
jroly81 · 08/08/2015 15:13
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Message withdrawn at poster's request.
Hi Jroly,
Long-time lurker here: been reading Mumsnet for a while, but joined so I could hopefully give you some of my experience (hope that doesn?t sound too arrogant). A kind of ?apology? in advance: I?m not too big on the huggy-supportive stuff rather than the technical, and my posts are likely to come across as a mix of Doc Martin and Sheldon Cooper?
My history: went on to 20mg then 40mg citalopram for depression the other year (probably triggered by surgery, but other stuff going back years also contributed). After a few months, decided to taper off as far as poss: I was 40, had just had a MMC (not problem with embryo), the previous uterine surgery, and had read a few studies that suggested a dose-related link between SSRIs and MC (and then I also found I had immune/clotting problems). Given all this, the decision to reduce (from the max legal dose) was a general ?doing the best I can? rather than a particular urge from the experts (by coincidence I got called into my GP surgery to discuss my dose just after I had moreorless decided I would do this, but they seemed less aware than me of all the issues and didn?t try to lead me into anything).
Did most of my tapering pre-pregnancy, but I?m now on 10mg (and 26w with my 1st), and here?s a few things from my ?journey? that might be helpful:
- Beware that the ?You must come off medications during pregnancy!? is a general precautionary one, and doesn?t mean that the particular one you?re taking has been found to be dangerous. Not just an issue with SSRIs, but there is so much of this with everything, that the message as to what?s truly dangerous (eg thalidomide, warfarin) gets confused. (T?Internets are some of the worst culprits here too, with apparently pregnancy-focussed sites taking great delight in eg ?informing? pregnant women of the dangers of ginger and lifting anything over 9kg, grr
)
- Even medical professionals don?t always see things in the round, focussed as they are on their own area. Someone who tells the patient to come off a medicine due to ?risk? is comparing that patient with the hypothetical healthy patient who has no reason to be on that drug. But it?s a false comparison: the point of reference should be that patient untreated. Most health professionals do thankfully realise that the risks of the drug must be weighed against the risks of not treating the underlying condition properly?although there is a danger that this is registered less in mental, rather than physical, conditions.
- Many drugs can?t be safely withdrawn from quickly, let alone cold turkey (and recognising this a particular problem if you have someone unfamiliar with them telling you to come off). IME, this is an area that online patient experience can be useful as a guideline. Lots of people report that even the protocol they were given by their GP for SSRI withdrawal was too fast. The one I devised for myself was blocks of 10 days, alternating to start 40, 35, 40? then 35, 35, 35? then 35, 30, 35? GP didn?t argue when I proposed it. Understandable if you might find this a bit slow now you?re already pregnant, though.
- Don?t be too hung up on coming off the citalopram altogether. From the research I read, what risk may exist depends on dose (as well as type) of SRRI: just by cutting it you?re doing good work?and unlike (eg smoking), it?s possible to stabilise at low doses, it?s not like you will addictively need to climb up again.
- For myself, I?m a believer in EPA/DHA fatty acids: basically, research seems to show them as a useful adjunct to SSRIs for treating depression, ie patients report a greater effect from a given dose of SSRI. (The research I?ve read was only SSRIs, though, and only for depression.) I?ve been taking fish oil capsules/oily fish equivalent to about 150g fish daily for the past 15 months. There aren?t really any contra-indications, so I figured the worst it could do was nothing, and I do think it may have helped. Obviously I?m not telling* you to go and do the same, but may be worth reading the professional sources on (and talking to your psych professional, if you have one (I didn?t/don?t)).
*Things to beware of: a) ensure you get fish oil not fish liver oil (and make sure any med professionals you tell are clear)?latter can be too high in vitamin A. b) stick within guidelines for oily fish consumption, and look out for oils that have been filtered, to avoid excessive heavy metals etc. c) fish oils may be a blood thinner, obviously look at in context of your other medical history, although you would probably have to be eating equivalent of several hundred grams fish daily for this to be a problem.
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