PND - BF and sertraline isnt working

[Honeymoonmummy]

hi all, I have been diagnosed with PND since DS was 7 weeks old, he is now nearly 7 months. Ive been on sertraline all this time, I've been on the max dose, 200ml, for about 3 months now. It seemed to be working at first but since DH went back to work in sept (college tutor), I've found it increasingly difficult to cope.

Then when we started weaning DS we discovered he had a reaction to a lot of food; long story short, for the past 2.5 weeks (and the next 4 weeks at least) I (and DS) can't have dairy, soya, wheat, gluten, egg, nuts, goats milk, fish, tomatoes and a few other fruit and veg. I'm basically eating chicken, potatoes, sweet potato, rice, special cereals and rice milk. I'm finding this really hard.

I had PND with my DD too, she's 3 in a few weeks, it worked with her.

I seem to recall 7 months can be a peak time for PND, is this right?

I don't know whether to persist with the sertraline or swap to something else, and if so, what? I'm BF. I tried some others with DD prior to sertraline and they didn't work, can't remember the names.

The anger I feel usually with my PND isn't bad so the Ad's are doing something, but I just feel lethargic and useless, I can't be bothered to go out in recent days, I can cope quite well with one of the children but I can't cope with 2. I just want to shut down and go to bed all the time.

Sorry for the self-indulgent post.

Self indulgent???? Nothing self indulgent about your post.

What a rotten situation, because while this food business is going on your bm is even more important to your ds than it is for other babies so the ADs need to work around this as you can't 'afford' to stop.

To be honest, the whole situation is so big, stressful and tiring that at least part of your lethargy can be explained by it.

You could do worse than having a chat with you doctor about it to see if another AD would be a good idea. If doc lacks knowledge ask to see a psychiatrist, not because you're mad but because they know more about different meds (GPs routinely only prescribe 3 or 4).

And be kind to yourself, this is a tough one.

If you are are still suffering with depression on 200mg sertaline then prehaps you need to discuss the possibly of changing medication with your doctor. Maybe you need more substantial support from the commuity mental health team. It is impossible for someone across the web to tell you what to do. You really need to talk a RL health professional.

The names of various medications that you have tried in the past will be in your medical notes.

Thanks both. I saw my doctor last week and she said I could either leave it another 4-6 weeks or change now. She's really good; problem is it usually takes about a week to get an appt with her! Never thought about asking for a psychiatrist.

Madmouse, your third paragraph really sums it up for me. I just can't be bothered to 'cope' with it anymore.

well it sounds like you have a lot to deal wiht, so be kind to yourself.

i took citalopram whilst preg nad bfeeding, my psych team did a bit of research and said it was ok, i found it worked for me.

and i second getting more help from the mh team, also maybe homestart?

Have you thought about CPT i think its called - taking to a counciler to be in a more positive frame of mind? It might help.

Also i think there is at least one other drug you can take when BF, if the max does is not working then you can try something else but its best to talk to the CMH nurse before changing.

It is hard to have two children and have PND as well.

I'm on 150ml of stertaline, i have a 2.8 year old and i'm 33 weeks pg. I have a family support officer, my HV, home support volunterre and Adult social services all involved to help support me and my family. They have even written to my midwife and consultant at the hospital who specialise in PND in pg. To me it seems OTT but they are all there to help me if (hopefully not when) i need it. My son goes to nursary 2 afternoon a week to give me a break, which helps alot. I have to say that my DH is disabled and i have no family or friends here to help me out so it really is down to me and the feeling that i can't cope is bad as there is no one else to look after my children, so i need the help when i feel really bad.

Have you thought about contacting adult social services or your HV to see what support is available to you?

Citalopram is what I tried first with DD and it didn't work. I don't like my HV, she's patronising and doesn't really listen and just winds me up but in my current mental state I couldn't request another one.

I don't like the idea of getting social services involved.

I tried counselling with DD and it didn't help.

Sorry I sound really defeatist! I'm normally a "cup half full" person, honest!!

Hi all, I just wanted to update this to say I contacted the HV (a nice one, the usual one is away!) and she is going to come every week for listening visits. I also contacted Home start and they are going to send someone round for 2 hours a week to help with the kids. I also contacted a Helpline set up to advise about drugs when bf and apparently after 7 weeks i can have mosy other ADs including prozac - but Ill give it a few weeks first.

I'm still pretty low but feel much better for making those steps. Thanks all.

Glad your feeling better and you are getting the help you need

That's major, you taking such positive steps to help yourself - well done. Do cut yourself some slack in other areas when you need to.

Hi all, u have tried to give the sertraline a few more weeks but it's just not working. I asked gp (not my usual one) to change and she said when bf there are only 2 other choices - citalopram (didnt work with my 1st) and another, can't remember tre name but it's an older type ad and is addictive so would have probs getting off it. Said these were the only 3 ads in the book which said ok when bf.

What else have other people been on and what worked? I have another appt tmrw with my usual gp so would like to have one to suggest.

Thanks Ristretto- will mention that one. Anyone else?

Bump

I've no advice as Sertraline worked for me, just wanted to wish you good look in finding something that can help you.

I stayed on fluoxitine and breastfed. Baby did suffer a week of jitteriness when I stopped bf, which wasn't nice, but maybe you get that from any ssri?

HMM - posted this in reply to another thread - but of use???

NICE recommend Sertraline cos it's apparently the lowest transference into breast milk. If you are NOT planning to BF you can use other ADs. If it doesn't work for you talk to your doc. I was switched back to another AD after 10 weeks BF as Sertraline didn't work too well for me, but we are all different. There see some great ADs out there - I gave up BF cos I wanted to feel closer to my son!!! And it so worked for me.... Hugs x