Please help - peroxetine and breastfeeding

[AdoraBelleDearHeart]

I am desperately in need of help. I have an obsessive disorder and severe anxiety problems, and it's effecting every thing I do.

I have finally seen a psychiatrist but he is hesitant to prescribe me anything because I am breastfeeding my ds aged just over one, and I plan on continuing until he is two years. He suggested peroxetine but he said it's not compatible with bfing.

What do I do. I am not going to stop bfing but I need something to help me because everything is falling apart.

BFN says paroxetine is safe in breastfeeding, and the NeLM data says it is a prefferred SSRI when breastfeeding.

Print those documents, and take them to the psychiatrist to discuss

My psych consultant recommends Sertraline (also an SSRI) during bfing.
Good links from CMOT. If paroxetine is best for you and safe, then you should take it.

Thank you. I have a lot to think about. I've only just come to realise that most of my problems are in my head and however hard I try they are not going to go away on their own. I'm not depressed; it's very specifically anxiety, possibly OCD but I'm not really sure what's wrong with me myself. I feel like I am going to fail everything.

Lots of studies seem to say different, esp. for a child that old. Use Google to find more.
Print this out.
And this.
Get info from Breastfeeding Network.
and take back to the shrink.

thanks, he did also mention Sertraline. I don't have another appointment for two weeks but I'm not sure what to do in the meantime.

Hi I was on paroxetine a few years back. Wasn't bf anyone then so can't help with that, but it did really help and I found it fairly easy to come off. Symptoms do get worse initially but for me it wasn't too bad.

Good luck.

Picante - what do you mean symptoms get worse initially? Is that normal? How long until it started to work?

It's completely normal - and common I think with most antidepressants as it takes your body a while to adjust. As I said for me I didn't really notice getting worse, just definitely noticed getting better!! Took at least a couple of weeks from what I remember.

Ok thanks. I have to go now to pick up the children.

Adora,

I have PND-OCD (and OCD tendancies from childhood) and have taken Sertraline since Dec 2006. I have bf DD1 from March 2006 until Sept 2009, DD2 from Nov 2007 to when ever she weans and DD3 from Oct 2009 to when ever she weans. In total I have clocked up 63 months concurrently whilst feeding on Sertraline. I have yet to notice any side effects in the DCs. I went on this drug after a lot of research (gotta love OCD ) especially on Thomas Hale's site as he is the expert on the effects of medications on breastfeeding.

I can also echo Picante's experience of things getting worse before they get better. The first two weeks of any anti-depressant are notorious for having big back slides into depression but if you know this you and your family/support can be prepared to give you extra help.

Good luck with your decision.

Thank you so much for sharing your experience Truthsweet.

Adora - just wanted to add with Sertraline and my recent CBT based OCD course I have gone fron 'Moderate to Severe OCD/Depression' to 'Normal to Mild OCD/Depression'. Before starting Sertraline I was actively suicidal and completely ruled by my OCD. Most of my OCD behaviours I have got under control and I can do some things I havent been able to do for years if ever. It was very hard work, I wont make out if was easy, but it is achievable with the right support. Is there an OCD group or CBT course your pysch can put you down for?

Admittedly I am back sliding a little bit now but that's due to having a 7 week old! Im nowhere near as bad as I was after the births of DD1/2 though.

Thank you Truthsweet. I am confused as to what is wrong with me; I'm not certain it's OCD, but the psychiatrist seemed to think that the anxiety was caused by some sort of obsessive disorder.

paroxetine is one of the preferred SSRIs, as it has a relatively short half-life. If you have difficulties in persuading your psychiatrist to prescribe, please ask him to liaise with a perinatal specialist (can give some names if you are in London, or NW England).

Martha - how would I find out the half life of the drug?

If I'm mostly only bfing mornings and nighttime, it is possible that I can take it after bfing, to avoid it going into my milk?

I just wish bfing was a normal thing, and then doctors would be a lot more up to date with what drugs are safe with bfing.

I'm not in London or the NE.

I agree adora re doctors needing to see bf as normal. I would definitely ask for referral to(or for psychiatrist to liaise with) a perinatal psychiatry specialist. Also these teams would have specialist pharmacists linked to them.

It's a hard area to provide concrete evidence for, as rigorous trials cannot be set up. But the rule of thumb with ANY drug is that where the benefits outweigh any potential risks then the drug can be prescribed.

'But the rule of thumb with ANY drug is that where the benefits outweigh any potential risks then the drug can be prescribed.'

That's the problem, not many people, not even doctors, see the benefits of still bfing past one year, not just the benefits to the child, but also the benefits to me.