Antidepressants in pregnancy

[Vickers1984]

Hi all,
Without going into to much detail, I’m 9 weeks pregnant with baby number 2. And I am really stressed out, feel anxious and really emotional. My doctor has prescribed sertraline ( I stopped taking citalopram about 2 months ago) but I am concerned about taking it, as I’m not sure of the effects on the baby. Any advice would be greatly received!

Baby will be on withdrawal observations once born to monitor it for withdrawing.

LOTS of people take it in pregnancy IME.

@Zebraaa do you know if that would be the same for amitryptiline?

I was on sertraline dc2. Absolutely fine. Wasn't monitored after either. It's a very common one in pregnancy

@BecauseItIz I believe observations would be the same for baby (in my Trust policy anyway- we are over cautious if anything) but it is less commonly used in pregnancy.

I’ve never seen a poorly baby due to mums taking these drugs. Withdrawal obs are usually fine.

Thanks for the feedback, it’s the withdrawal I’m most worried about, but I'm also worried I may loose my mind if I don’t take them!

@BecauseItIz it was the case for me and my dd in 2016. I took 50mg amitriptyline from after 12 weeks until past birth. We stayed in hospital an extra night for observation but there was no big deal made about it at all.

I was on Amitryptiline during my first pregnancy. With hindsight it wasn't effective and I was very mentally unwell. There was never any mention of withdrawal or extra monitoring for baby and we were home the day after my ELCS. That was in 2015.

This time (baby is 14 weeks now) I was on Fluoxetine. Much more effective but baby had to be monitored for withdrawal. They thought he was "jittery" so we stayed in for three nights but he showed no other signs of withdrawal. He still has a quivery bottom lip now so we think it's just something he does. In my opinion a happy, relaxed mum is what's best for baby. If you need the meds, take them. All the best.

It's not ideal, but you weigh up the risk vs the risk to your mental health. Sertraline is lower risk than many other antidepressants and has very low serum levels in breast milk too (if you plan to breastfeed).
I recently started antidepressants following a missed miscarriage and I chose sertraline as a number of studies pointed towards it being a low risk choice for pregnancy and breastfeeding, and I didn't want to have to spend months coming off something if we feel ready to try again.

Thanks for that info. I stopped taking them and felt really ill physically so I started again. My booking app is the 9th I shall ask then. It's scary to think if I felt ill how will my baby feel.

Sorry to jump on your thread there op! I hope it helps with your anxiety and you have an easy pregnancy.

I came off antidepressants when I found I was pregnant with DC2. I was taking prozac the GP made a comment about it been a good thing I stopped them.
It made me determined to stay off them, by 6 months I was deeply depressed, angry, frustrated, it was awful I didn't know myself, everyone around me deeply concerned.
My consultant put me in a different AD at 6mo it definitly helped, though it was to late I didn't recover in time for the birth, I didn't get to enjoy DS as a baby.
Things may have been different if I'd stayed on them. To add he did have gittery shakes and jaundice but didn't need monitoring.

@Vickers1984
I'm reporting your comment.. that is such a dangerous thing to say to a woman at a really vulnerable time. Mental health isn't a "very awkward situation" ffs.

Sorry wrong tag
@highinthesky

OP, I would be VERY dubious about taking any medical advice whatsoever from people here, no matter who they say they are.

Follow your GPs advice.

I didn’t see their comment?! I thought I’d said something bad then for minute! phew!

Where do you think the people who took antidepressants during pregnancy got their prescriptions from @factorfifty.

Op, if you do want to speak to someone about meds during pregnancy ask for a referral to the psychiatric services on your area or a specialist mental health midwife. Gps don't usually have enough experience in treating pregnant women, and will err on the side of caution, but the psych team should have people with far greater knowledge and understanding with respect to your needs. You will also gain contacts that you can use of you need any further support after both.
Good luck.

It’s not so much medical advice, I’ve got the go ahead from my doc and midwife. I think it’s reassurance that I’m after, from people who have been in a similar situation.

Mental health isn't a "very awkward situation" ffs. The decision to take regular medication during pregnancy always is, though.

I did not say that MH is!

Butterchunks - thank you, I will ask my GP for a referral

This web page bumps has information about the risks if you'd find that reassuring? (mostly risks are likely to be very small, but meds don't have the same testing in pregnant women).

I completely agree with @Butterchunks and I should have mentioned that myself. My GP was very cautious and swapped me to Fluoxetine from Sertraline after a miscarriage a few weeks before because she had read that it was slightly lower risk. She also referred me to a new perinatal mental health team from the women's hospital. I quickly had an appointment where I saw two psychiatrists together! They said the difference between the two meds was negligible really, both believed to be very safe during pregnancy. The only definite thing they told me was that up to a dosage of 20mg a day on Fluoxetine, I could breastfeed if I wanted to. Any higher and I couldn't. For me the benefits to having stable mental health were massive for both me and baby, and I chose this over breastfeeding. Not sure my anxiety could have coped with breastfeeding at the best of times. I have no regrets.

Ffs a lot of people take regular medication throughout pregnancy because they live with physical or mental health conditions. I have asthma and continued inhalers as well as needing antibiotics a couple of times. Is that an awkward situation?

OP you'll find many pregnant mums and even more postnatally take sertraline. Its more common than you think. Pharmacists are a great and underutilised resource if you have medication queries.

I think you have to balance the risks of a mental health crisis around pregnancy/birth against the risks of taking the medication. I came off mine while TTC but that was because I was taking them out of habit and quite certain that I didn't need them any more. However, it was still a huge risk considering that within the year, I was mother to 2 newborns (one conceived, one adopted)! If I knew that things would go that way, I wouldn't have taken the risk and waited till we were settled because obviously it was chaos.