Gobsmacked at SSRI / pregnancy thing as reported on BBC today

According to this report one in three women and girls are on antidepressants at some point in their lives.

I wonder what would happen if all pre pregnant fertile women stopped taking them. I suspect the country might grind to a bit of a halt

Lurcio while I agree with most of what you wrote, some of us on long term meds (not just ADs) talk to our doctors before TTC. It's galling that, yet again, women seem to not be considered as sensible enough to talk with their GPs prior to pregnancy...

Lurcio I agree with a lot of what you said (wrote?). Isn't it sad that pregnant women are only faced with what seems to be a litany of Don'ts and Mustn'ts with no real consideration of alternatives.

Wouldn't it be better if NICE could say, look, SSRI's are not ideal in pregnancy but look, here is another AD that is just as effective and will not cross the placenta.

One of my favourite rants is "if men got pregnant they would have solved it by now". In spades.

(also applies to periods and the menopause).

From the NICE website

NICE Public Board Meeting (Annual General Meeting)

Every two months the NICE Board holds its meeting in a different venue; moving from region to region to ensure that all those interested in our work can come along to hear about the latest developments at NICE and question the Board about policy.

NICE Question Time

A question time session is held before the main Board meeting. This session offers a great opportunity for you to raise any questions you have about our work and is open to the general public.

Attendees will have an opportunity to put their questions to David Haslam, Chairman of NICE.

NICE Question Time is open to the general public

Board Papers

Agenda and papers (to follow)

NICE Question Time - Stockport

Time: 12.30-1.30pm

Lunch is provided from 12 noon.

OK, I too fumed at this article, because of the assumption that women's mental health was trivial and unimportant compared to that of their hypothetical unborn baby, thus making us seem like incubators on legs (once more).

However, I didn't see him use the phrase "pre-pregnant" anywhere. And it seems to me a reasonable part of informed consent to tell a woman that certain drugs are contra-indicated in pregnancy. After all, you don't have a statement in your medical notes saying "I intend to get pregnant in the next 6 months/ I hate the whole idea and never intend to get pregnant." So the doctor has an obligation to consider the possibility and inform you that hypothetically, were you to get pregnant, there could be problems. I didn't have a problem with the endocrinologist I saw telling me this about my thyroid medication many years back, and I don't see a problem with a doctor discussing the issue with a woman presenting with depression - depression does not remove your capacity for informed consent, nor for the need for the information required in order to give or withhold that consent.

The important issue is to tell women that SSRIs change the risk of congenital heart defects from (if I read the article correctly) 2 in 100 to 4 in 100, and ask her how she feels about that increased risk balanced against the risks posed to her of not having her depression treated.

The issue for feminists is to make sure that the decision making process is not taken from the women and handed over to the doctor, in the form of a blanket ban on SSRIs for pre-menopausal women (and I've seen nothing in the press coverage to suggest that this was being proposed). After all, even if it increased the risk from 2 in 100 to 98 in 100, it's perfectly acceptable for a woman to say "give me the SSRIs, if I become pregnant and the 20 week scan shows a heart defect, I will have an abortion secure in the knowledge that I made the right decision for my own mental health." (By the way, I am not saying that this is the only decision, or the decision which is right in absolute terms - I have close friends who have chosen to carry a baby with a serious heart defect to term, and that decision was right for them; I just believe very strongly that only the woman who is pregnant can make the decision about her own pregnancy).

The more I think about this the more annoyed I feel. Two things really irk me:

1. 'mild to moderate'

I stand corrected NiceTabard and I, for reasons of being pre-pregnant at all times for the next few years, promise not to drink, eat brie/paté/peanuts/whatever today's no-no is, take any kind of SSRI or any kind of hormonal contraception.

Do you think that we, as women, should inform doctors and pharmacists that we are pre-pregnant when they write or fill an Rx for us? Should I only buy maternity clothing as a sort of 'just in case'?

Honestly, the more I think of the concept of pre-pregnancy, the more I fume!

PRE-PREGNANT

WHAT

THE

FUCK???????

So what does he suggest?
I hate to sound all Apprentice, but I'm sick of these reports 99% aimed at women, that highlight these things but never a solution.

How many women will have gone on to have serious clinical depression with these meds?

Or does that not matter?

Silly me of course not they're only women..............

Well, if I hadn't had SSRIs in my early thirties I would not have been alive to give birth to children in my 40s.

I share the annoyance and concern about this, but let's face it, women are routinely spoken to and about like this. Only recently they were subjected to messages telling them to avoid any number of everyday chemicals, foods and other stuff while pregnant, due to an unquantified risk of harm to the unborn child.

All responsibility and blame is placed on the pregnant woman, not on wider society to make changes that benefit and protect pregnant women and small children. This latest scare fits neatly into that pattern.

This makes me sad.

The idea of calling the next fuckwit who uses the phrase pre-pregnant a pre-inseminator makes me happy, though.

This gives me the RAGE.

Absolutely unbelievable.

Good deduction, NT. I await a BBC headline saying 'Heterosexuality is bad for you.'

Actually there is some evidence (am not medic so can't judge it) that SSRIs can cause sperm quality problems in men that can be potentially linked to a higher risk of birth defects.

www.cornellpsychiatry.org/about/male_fertility.html

Bafflingly, I have yet to see an article on the BBC warning pre-inseminating men who are suffering mild to moderate depression not to use SSRIs for this reason.

Misogynistic twat.

SSRI's quite literally saved my life at one point, luckily (according to Prof Pilling) I had already been talked into getting myself sterilised, so never pre-pregnant again.

What a very dangerous and mother blaming piece of reporting as NiceTabard rightly pointed out, can you imagine the outcry should men be classed as pre-inseminating unless they are pre-pubescent or dead, and therefore should avoid the various things that women do?

Pre pregnant? Only if he can fucking sort my DH's sperm out!

When we were TTC I specifically changed SSRIs on the advice of my gynae to ensure that any hypothetical babies were not harmed. No kids are forthcoming (aforementioned sperm problem) and I should be able to take whatever I fucking like.

The irony is that our fertility issues triggered HUGE depression for me - but yeah, I was only taking them for fun.

bloody hell. Pre pregnant? He can fuck off

Brutal is the right word. Expecting women to be in a state of pre-pregnancy is just treating us like breeders. Not people with a right to a life.

Fuck. The. Fuck. Off.

You should SUFFER, NiceTabard, for the sake of your hypothetical unborn child.

Given that women have a childbearing life of, on average, about 30 years it is an extraordinarily brutal sentence.

Cross-post with mooncup. Yes I was thinking of the same report. So vague you could probably put any household goods in there