Experience of Citalopram in pregnancy?

[PussinJimmyChoos]

Was on 40mg of Citalopram which I stopped as soon as I found out was PG.

Have struggled quite a bit with the come down and am generally quite anxious, tearful, don't like being alone and find myself worrying needlessly about a lot of things

Dr said I could go back on the Citalopram if I wanted to as you can take it in preg but I'm pretty worried about doing so

Am 10 weeks tomorrow which is good in that a lot of the groundwork has been done for the pregnancy and haven't taken meds during this crucial stage, but am just wondering how long I can cope without the meds

Dr also said I would need to wean myself off of them near end of pregnancy...so I'm thinking what is point if am only taking them for 3 months or so...also, said I can't breast feed if I am on them, which I want to do

I'm sure I've read on here of mums taking them full term and breasfeeding??

Any experiences appreciated

I'm a MH nurse and the advise generally is antidepressants should not be used during pregnancy unless the potential benefit outweighs the risk.

In the first trimester it is possible it might affect baby's development although studies are starting to show this might not be as bad as first thought, although doctors are still very reluctant to prescribe.
In the third trimester there is a bigger risk of toxicity to the baby and neonatal withdrawal symptoms. So you would definitely have to come off them by then.
If you want to breastfeed your best bet would be to try a different antidepressant.
The following is quoted directly from the most recent research I'm aware of:

"Even though all SSRIs are excreted into breast milk, no serious adverse effects have been reported in children whose mothers were taking SSRI during breast feeding. Recent review (23), available on use of SSRIs during breast feeding, suggests that exposure for the nursing child is lowest with sertraline and fluvoxamine,higher with paroxetine and highest with citalopram and fluoxetine.Authors concluded that available data are insufficient to form a basis for clear clinical recommendations as to which SSRI is the safest to use during breastfeeding. They could not find a reason for changing an ongoing successful treatment with a particular SSRI to another which is excreted to a smaller extent."

Further to that though is the possibility of a tricyclic (older style antidepressants). The following is from the same research:

"The limited evidence available for Tricyclics suggests no short term toxic effects for the infant except in the use of doxepin. No long term developmental effects for the infant have been demonstrated. A tricyclic with a short half life for itself and any active metabolite would appear to be a better option. Amitriptyline and Imipramine are the preffered tricylic antidepressants during breast feeding(46)"

Please let me know if you'd like any more information. I know all of the above is a lot to take in and not easy when you're struggling with feelings of depression but I'd be more than happy to help where I can.
I had post natal depression after my first so I can imagine how torn you must feel! All the best xxx

Meant to add aswell, you're probably experiencing withdrawal symptoms yourself which probably aren't helping matters.

Go see your GP asap and ask them to refer you for CBT (Cognitive Behavioural therapy), don't let him/her fob you off. Research shows it's as effective as antidepressants! I use it as part of treatment with my patients and it's amazing! In the meantime get as much support as possible from friends, family, etc as you can.

citalopram is quite difficult to come off of the withdrawal symptoms can be terrible. I have been on citalpram, for 4 years now so there was no way I could just stop cold turkey in this pregnancy (am 10+5) The reading I have done indicates that the highest risk is in the 3rd trimester with neonatal withdrawal symptoms. I am tryin to wean off slowly. I was on 30mg have reduced to 20mg 2 weeks ago and will try to get down to 10 in the next few weeks.

Sertraline and prozac are considered to be the 'best' ssris to use while breastfeeding as they are not present in breast milk in high levels, thereofe if I find I cannot cope without medicatiion I will ask to switch to sertraline.

me23, please don't consider a switch to Prozac, it isn't one of the 'best' at all, in fact it's one of the worst for bfing. Sertraline is though.

I'm sure I've read that a lot of people have taken citalopram with no problem though

Thing is, I'm sure CBT is very good but I want something that will work within next few weeks as feeling like this is no picnic..having said that, I am managing as my desire NOT to be on any meds in first trimester at least is strong

What is point though of taking meds if have to wean off of them later in pg....

Am sure there must be hundreds of women with MH issues that take meds and babies are fine

Its a tough call

With CBT you might have to wait a few weeks for therapy but it might be worth badgering your GP anyway to refer you.
In the meantime check out www.livinglifetothefull.com
or
www.getselfhelp.co.uk

Hi Puss,

I'm in the same situation.

Am 6 weeks pregnant and was told today by GP I should stop my 50mg of sertraline. I feel a bit nervous about it, am already on the waiting list for CBT so am hoping that will help.

I feel like its a really shitty position to be in because I feel like I'm making a choice between whats best for baby and whats best for me :(

After reading this thread though I think I am going to come off it slowly as I don't want to have to deal with withdrawal in the last trimester as its a stressful enough time already!

The problem is - I don't know what causes my panics/anxiety and I know I can cope a lot better on ADs...kind of thinking its unfair on DH and DS to not have me 100% (although have to stress DS's care is in no way compromised and I don't think he is even aware of how down I am)

Mind you, I am very sick with first trimester sickness atm and that is making me very miserable. Am hardly going out, not able to work so part of me is waiting for this to stop so I can really see if its actually me or being stuck in due to being sick iyswim?

I have been told there is no reason to stop citalopram if pregnant. I can't come off them instantly, I am currently ttc and am trying to wean myself down to a lower dose gradually.

BOLLOCKS! Excuse me, but being on the other side now of having had a terrible pregnancy and being completely insane, it's absolutely FINE to take citalopram. Thousands of women do. There is no evidence to show it does anything at all to the child. Believe you me, I've researched it for years and years. It's far far better to be sane and keep it together for the sake of your family, I promise you. Don't let anyone scare you, or guilt you out of it. If you have trouble with panic and anxiety in normal life then with the bonkersness of pregnancy on top, you're entitled to all the help you can get.

I tried loads of time to come off to get pregnant, but then on the advice of two separate psychiatrists I stayed on them while ttc. At about 20 weeks pg I started to feel mental again (anxiety and panic big time) and was told that often the increased metabolism and weight gain means that most women have to increase their dose. So I went from 20mg to 40mg and felt okay again.

Now my girl is 5 months old, big fat and laughing and I have avoided the worst of PND. Seriously, no one batted an eyelid on any of the wards that I was on the meds, and most people said that it was becoming increasingly common for women to continue their meds in pregnancy. It is totally unnecessary to come off. Please don't beat yourself up about it, stay on them, and enjoy your pregnancy.

And the breastfeeding stuff is also bollocks - only an absolute max of 10% of whatever you're taking goes through to the breastmilk, as opposed to loads more crossing the actual placenta. My girl had no withdrawal effects, and breast fed very happily thanks very much.

Do not believe the hype! Just look after yourself. Your baby will be fine with a happy (or at least less bonkers) Mummy. Have SO been there, and it makes me so cross!

GOOD LUCK XXXX

oh yes, sorry I got confused there meant prozac is considered best for pregnancy! not bf as it has long half life.

sorry - I meant Bollocks to all the GPs, not to any of you! How rude... x

Fireman - did your DD get withdrawal symptoms at all?

I think the issue is that while I can think ok, it seems fine to take them in preg...the fear is there that if there was something wrong with the baby (God forbid) I would never know if it was something that would have happened or as a result of the ADs - directly or indirectly

firemansam - great post - I totally agree - coming off and feeling like shite is not going to help any woman through pregnancy - well done for sharing your experience, there is so much hysteria that goes on around this subject!

I'm still holding off going back on the Citalopram...Dr said could take it now if I wanted to but would better to wait until week 13...ie past crucial first trimester stages

Thing is though, I feel like shit every day...

How did others feel? Did anyone else hate being in the house alone?

Bumping this...going back to Drs tomorrow as think I may need to start the ADs again - not doing great without them

Is it ok at 11 wks do you think??

Hey i know it's a few weeks since your post but just to say i was on 20mg Citalpram for my whole pregnancy and for the time i breastfed. I asked my doc right at the beginning if i should come off them and she said no because it was better to keep me sane and happy than any potential risks to the babba. which is prob just as well cos i had the worst pregnancy ever! and never once felt anxious or properly depressed. Had sickness all the way thru, every silly symptom like shortness of breath, stuffy nose, nose bleeds, insomnia,chronic indigestion,carpal tunnel syndrome,oedema, obstetric cholestasis (which caused severe itching over every inch of my body) then finally pre-eclampsia!!!!!

My ds had NO withdrawal effects from the citalopram either after the birth or when i stopped breast feeding.

I will def still be on them for my next pregnancy ...if i am crazy enough to do it again!

i say go for it!

Jess - thanks for your reply. I managed to make it to 12 weeks with no ADs and then went back on them last week...midwife was v chilled out about it when I told her and said had lots of her ladies on ADs and not to worry

Am consoling myself with fact that I wasn't on them for the crucial first weeks so makes me feel not such a bad mum!

Good. now things can only get better!

I took Citalapram whilst pregnant with my second child, I had PND with the first so came off them for for 12 weeks into the pregnancy, then went back on them for about 9 months, didnt have a hard time coming off them, My children are 18 months apart, I live in an isolated area in the south of England whilst all my very large family live up north. I felt I couldnt cope with another baby but the citalapram helped me with my hormonal moods and anxiety of second pregnancy. You cant get addicted to Citalapram, thats not true....