To think the GP should have pointed me to this? July 2020 research Sertraline ‘safe’ in pregnancy

[UncleBunclesHouse]

At my appointment to discuss SSRI medication for depression during pregnancy I was pointed towards an NHS leaflet in which research concluded a small but greater risk of heart defects. I stopped taking the meds, now really struggling. In my own reading found the below which is newer and says, for Sertraline specifically, no link was found:

www.cdc.gov/pregnancy/meds/treatingfortwo/features/ssrisandbirthdefects.html

Can any of the great minds on here explain any reason I can’t take this at face value? As far as I understand the CDC is credible, so why wasn’t I pointed towards this study?

Because NHS policies are based on more than someone reading the most up to date research and clicking a button. Unfortunately

@whiplashy would you mind elaborating? Do you mean cost?

Sertraline is considered relatively safe as are all SSRIs.

New research takes a long time to filter down into policy. There's nothing to say there won't be new research next month that contradicts this one so we tend not to change policy every time a new study is released or we'd have to change back and forward every week. I've not read the study you've linked to so I can't comment on the quality of it.

At the end of the day it's always going to be a risk benefit analysis. If you're really struggling, then go back on the antidepressant. The risks are small, although not non existent as far as we know.

Honestly, GPs are not up to date with this kind of thing often and/or are very risk averse. I took the max dose of sertraline throughout pregnancy as agreed with my psychiatrist, midwife, consultant and the perinatal mental health team. It's the safest one to use and my consultant said she often advised women to start taking it towards the end of pregnancy (or upping their dose) if there was a significant of PND.

Thanks @justchecking1 this is really helpful

@mynameiscalypso I’d just expect to be pointed to it at least to help make a decision - appreciate the G in GP means can’t be an expert in everything but I found this quickly and easily with no medical knowledge in this area. So hard already to make these decisions without only seeing fairly dated research

@mynameiscalypso I’m not allowed to be under the perinatal MH team - have asked - I’m apparently not a severe enough case. I make great efforts to hide it well. I have tried to explain I hid how bad things were in last pregnancy but that’s the message.

Oh I totally agree; it's not uncommon to take SSRIs during pregnancy and it's the kind of thing they should be on the ball about. It's mainly why I never bother seeing my GP!

DD took sertraline throughout her last pregnancy, her son needed to be checked if he was born with (a very small chance of) add, he was fine and now is an adorable 3 year old.

Personally I think your dr was right to advise you that there are risks associated with SSRIs. Whilst they are generally considered 'safe' during pregnancy they are not without risk. I actually found it the other way around in that I was more risk adverse than the medics. I was advised to keep on taking my high dose AD throughout as the risks were small to baby, but the risk to baby if I was unmedicated and deteriorated could be much higher. I understand that, but personally I wasn't prepared to take the risk and felt pressurised and not listened too.

Once queried with a consultant when prescribed something that was contra indicated with something else I was taking.
His response - "well I don't read patient information leaflets" - maybe not, nut I'd have expected anyone prescribing to have access to basic information like that

*but not nut

I was told recently when I asked about the potential of having a baby in the next few years that I should try switching to Sertraline (from Citalopram) ahead of conceiving as it's much safer and the recommended choice in pregnancy, so I would definitely query it!