Anti-depressants during pregnancy

[susurration]

I was wondering if anyone had any experience of taking anti-depressants during pregnancy please?

I'm on 40mg escitalopram daily (which is double the recommended dose, but was agreed with my psychiatrist and GP) for chronic depression and anxiety. I've been very ill and only really well since Aug/Nov 2014. I started this med in May 2014. We are currently just starting TTC #1.

I do NOT want to come off my medication. I've done a lot of reading around what is safe in pregnancy and know that SSRI's are not recommended but sertraline is the drug of choice for most psych consultants when pregnant/breastfeeding. I've read up about the possible side effects and feel informed.

I have an appointment with my psych consultant in a fortnight. What should I be expecting? Any advice or experience welcome.

The only thing I know about it is this - we lived next door to a little boy who had had 10 open heart surgery operations by the age of 8 because of heart defects most likely caused by the anti-depressants his mother was on during the early stages of pregnancy (before she knew she was pregnant).

You need to talk to your GP as they will be best placed to advise you.

I am on citalopram, when I found out I was pregnant I saw my GP who advised I tried to come off them by the third trimester. I knew this would be a total mistake so I cut down from 20mg to 10mg until of had my 20 week scan and saw that babies heart etc was ok. I then went back up to 20mg but it took a while to kick in again. I had 4 months off work in total. I'd agreed with my GP that as soon as baby was born id go up to 40mg as I had horrific PND with my first and so far 7 weeks later im feeling ok. One GP I saw when I was signed off was happy to put me up to a maximum of 40mg when I was pregnant and the ante natal psych team were too. They agreed that the benefit to me hugely outweighed the risk to the baby but I decided to try and manage on the lower dose.

As with every drug there will always be some risk, but it is very small and lots of people take citalopram throughout pregnancy with no problem though of course it's up to you and your drs to make that choice.

Good luck

I was on 60mg citalopram whilst ttc but was switched to fluoxetine before we conceived. This was due to the cardiac risk.

I've been on a reduced dose of fluoxetine since I had a positive PT (20mg/40mg on alternate days) with a plan to up it to 40mg daily on delivery.

If I'm honest I feel crap. Fluoxetine doesn't suit me as well as citalopram and I can't wait to up the dose of fluoxetine. As soon as I stop (hopefully) BF I'm going to ask to go back to citalopram at a reduced dose.

All I can suggest is that you weigh up the advice from the experts with how you feel. There is no point in avoiding a minimal risk if you're going to spend 9+ months of being high risk from a MH perspective and be so depressed that you can't function. You need to be able to live as normally as you can - pregnancy is a huge strain as it is, change is enormous and with the extra hormones floating around it can be even more difficult.

Apologies for the slightly late reply.

fizzycolagurlie thanks for your reply, but i was really hoping to hear some experiences of people who have been through something similar, not scare stories. I have read about and understand the risks and know I need to speak to my consultant, as I said in my OP.

worriedaboutwee and ohfourfoxache (very cool name btw!) thank you for sharing your experiences. I think my consultant will probably want to reduce or change my medication anyway as escitalopram is apparently still a patented med and so costs the NHS more than normal citalopram would. I'd really rather not change though as its working for me at the moment.

Reassuring to hear you've both been allowed to continue medication whilst TTC and pregnant. I agree that its a careful balance between the risks to the baby and considering how ill I would be without the medication. Going by how ill I have been in the last two years though I think that I will need to remain on the medication to have any hope at all of getting through a pregnancy and the post natal period unfortunately.

Thanks again!

Ssurration. I didn't tell you about my neighbor to scare you, I told you the truth, the reality of what you need to consider.

You made no mention of this in your OP, you just said you had read widely on it, without any specifics in terms of the potential consequences.

I sincerely hope that you can find the balance in your meds and in your life that you can fufill the desire to be a healthy parent to a healthy child. Good luck.

I suffered from pre natal depression whilst pregnant with ds.
I was prescribed anti depressants from 20 weeks. I can't remember what they were called. They were the old fashioned kind not modern day ssri
I took them until term and then switched to a different type.
My ds was healthy and did not suffer any after effects at all.

fizzycolagurlie I said in my OP I had read up about the possible side effects and that I feel informed. I know what the risk is considered to be and what it increases to if you take SSRI anti-depressants. Thank you though.

uggmum it sounds like you were maybe prescribed a tri-cyclic? They seem to have far less incidences of documented side effects on foetus and baby, part of which is apparently because they have been in use longer and so there has been more study. Its good to hear you were allowed to take the tri-cyclics though. I'm not sure i'm keen to try them due to a specific possible side effect on myself that I think I need to avoid. Thanks!