Sertraline question

[Yaty]

Hi I just wondering if anyone has been in the same situation and can give some advise. I've been on 100mg sertraline for depression for nearly a year now. I'm currently 28+6 and starting to worry about needing to wean off before my due date. I've spoken to a consultant who said it was the best thing to do as the baby can experience withdrawals in 1st few days if I'm still taking them. I spoke to my midwife and she wasn't as strong in her advise and said it's up to me and I need to think what's the best long term. I'm reading loads of conflicting advise about it and I'm really confused.

On one hand I definitely dont feel depressed anymore and the sertraline has obviously helped. I think I'd be more inclined to come off but then I'm anxious about the lockdown situation and the extra stress of that. My family live other side of the country and it's been hard not seeing anyone. I'm wfh and dont see friends because of lockdown. I just think this could be the worst possible time to try and get off the meds. But then I feel guilty for what my baby might experience of I dont.

Sorry for the long message but I really dont know what to do. Has anyone been in the same position, what did you do and what was the outcome?

[VestaRose]

I went down to 50mg at the beginning of my pregnancy and still taking it now at 27 weeks. Nothing has been said to me about coming off them, but I will ask at my next appointment. I'm a bit concerned about pnd and will continue to take them unless advised otherwise. Would reducing the dose be an option for you?

[Thenextplateau]

I was changed to setraline while I was pregnant with dd1 as you can bf while taking it. Second time I just stayed on my venlafaxine at a reduced dose, and formula fed. They told me that while it is obviously safer to take no medication at all while pregnant, they were more concerned about my increased risk of pnd.

Maybe worth speaking to a different doctor?

[CoolNoMore]

I have been told, with much confidence that sertraline is 100% fine in pregnancy and for breastfeeding. I would keep on it until you're past the properly crazy sleep deprivation stage. As @Thenextplateau says, another opinion would be useful here.

[Nelbert19]

I’m also taking 100mg sertraline and won’t be weaning off as I would then worry about increasing my risk of PND if I stop my medication just as the baby comes, bringing sleep deprivation, massive hormonal changes and basically turning my life upside down!

The hospital have said I’ll have to stay in for 48 hours post birth to monitor the baby for withdrawal, which is fine by me - comforting that we’ll be looked after for the first few days and allows my DH to be fully rested so he can look after us when we get back home!

Can you ask for referral to the perinatal mental health service for advice? They’re the experts in this field

[Yaty]

Yeah I'm also worried about PND so I was quite surprised when it was suggested to come off! @CoolNoMore this is what I was told by my GP when I first found out I was pregnant, in fact he increased my dose form 50mg. So no wonder I'm confused!! @Nelbert I was told when I spoke to the consultant I'd be having another appointment I think with the MH team but not had anything through about it so will chase it up thanks. I didnt know I might have to stay in with the baby.
@Thenextplateau if you dont mind me asking did your dd1 have any withdrawl symptoms? I'm hoping to breast feed too so surely the baby would be getting the medication through that anyway so no withdrawl?

[CoronaBaby]

I went on sertraline towards the end of my pregnancy (36+4 but ended up having my DD at 36+5 - totally unrelated) I was on 50mg and prescribed for anxiety and low mood, I was never told anything about baby having withdrawals. I went on it in the hope to lift my mood before my baby was born but she had other ideas clearly 😅 I came off it when she was 6 months old and I have EBF the entire time! I would double check the advise given as I was never told of this!

[ClaraLane]

I was on 100mg when my baby was born and went up to 200mg shortly afterwards. I breastfed her until she was 17 months so definitely no need to worry about coming off it. I was worried about her withdrawing but she was absolutely fine, perhaps because I breastfed.

I’m pregnant again and currently on 50mg and will be breastfeeding again. The only reason I’m on a lower dose this time is because I wanted a bit of leeway to increase my dose later on if necessary.

Please don’t stress yourself out about stopping, it’s very unlikely your baby will experience any side effects and making sure you’re well is incredibly important.

[ClaraLane]

Are you under the mental health midwives? I was first time round but don’t feel I need it this time round. They were incredibly non-judgemental and helpful though so I really recommend asking for a referral to them if possible.

[Yaty]

Thanks @ClaraLane I feel better knowing others have stayed on with no problems. No I'm not under the MH midwife. To be honest I dont feel I really need it I've been doing well MH wise even with all this corona stress. My main concern is just the thought of having to come off and possibly increased risk of PND. I think I'm leaning towards staying on now after hearing everyones experiences.

[UrsulaSings]

The GP telling you to come off your medication just before baby is born sounds like madness to me!!

I am under the perinatal mental health team and they said that it is fine to stay on medication and that if you are able to breast feed then this reduces the withdrawal for baby anyway because they are getting a small amount in your breast milk. They were very reassuring. In fact, when I said about concerns about being on medication and the physical impact this might have on baby, they said that the potential for my mental health to go south is more risky and that if I'm not mentally OK when baby is here then this could be more detrimental to baby anyway, and that it is all about weighing up risks.

I would definitely chase up the appointment with the mental health specialists, because they're the ones that really know what they are doing. My GP advised me to come off my medication when I first found out I was pregnant, and that was definitely the WRONG advise because I ended up suicidal and more at risk and having to have intervention from perinatal mental health (who have been wonderful, I might add).

[mynameiscalypso]

I was told very definitively by my consultant not to come off them - in fact, she suggested increasing my dose 4 weeks before birth to prevent PND. If you're planning to BF too, baby will still get some that way (I didn't, made no difference to DS).