GP told me stop/reduce med(sertraline) whilst pregnant!? Advice/comments?

[Ooopsie]

I replied to a thread the other day but OP was 2009 so thought I'd try find more up to date posters dealing with same or with advice?.

I've been on 100mg Sertraline since suffering with PND in 2003, had previously suffered with depression but never prescribed meds. I've tried with my doctors advise to reduce my dose before but symptoms of depression and anxiety returned so I was returned to 100mg.

I'm now pregnant again and the GP has recommended I come off them altogether but first to reduce to 75mg for three days then to 50mg. 75mg was fine, but at 50mg I felt the mood swings and depression rear its ugly head so I upped myself back to 75mg last week and returned to see my GP today. He was very unhappy and told me to go back to 50mg immediately, and if I disagreed to speak to the consultant at hospital when I see him at 20 weeks.

In addition to being signed off work due to severe 24/7 nausea last 4 weeks which has me feeling utterly fed up, I now feel worse than ever with the attitude of my GP.
Not sure how to get a second opinion?

Hi Oooopsie. Sorry your GP is being a bit of a k**b. I'd ask to go and see someone who specialises in antenatal/postnatal mental health. Your midwife might be more helpful than your GP. Or another GP at the practice? He's really not very understanding of your situation, is he? I saw a specialist psychiatrist but I think there are nurses as well (not entirely sure). Have you got a mother and baby mental health unit near you? I know that there are AD's that you can take when pregnant.

Thank you, reassuring to know I'm not the only one who thinks he's one of those ha.

Unfortunately he's the only GP at my practice. I had my booking in appointment with midwife last week (before I went back to GP) who mentioned referral to a anti-natal midwife who specialised in women taking ADs, but will prob be few weeks until I hear from her, as for a unit I have no idea. Unfortunately they took my notes that have all the telephone numbers on and I won't get them back til I have my scan at end of month. Might just ring general anti-natal dept number at hospital and see if they steer me in right direction.

Hi, I'm really sorry to hear what an un-professional div your gp is being, he obviously doesnt keep up with recent research and guidance, which he's meant to!!! Im a 3rd year (3 months left woohoo) mental health nursing student with a major interest in perinatal mental health and have spent a long time researching and working with women in your situation. Firstly Sertraline is safe to take during pregnancy, there is always a risk with meds, but to date there is no evidence to suggest harm to your baby. you should be advised to reduce your meds to a level that you can cope with, but to NOT come off them altogether unless YOU choose to, not your GP!!!! There are fantastic specialists mental health perinatal consultants and nurses that work in MIMHS (mother and infant mental health services) they can give you the best support and advice in what ever you choose. to be referred to them you first have to be referred to the community mental health team in your area this has to be done through your GP. it sounds like a nightmare process, but its so so worth it. there is a chance that MIMHS wont take you on their case load as they only take severe cases, but they can contact you gp, midwife and community mental health team and give them advice and upto date info to best support you.
I really hope this helps you and offers some reassurance, all the best :) x

P.S maybe you should tell your GP to read the NICE guidance for antenatal and postnatal mental health (2007). he is meant to after all!!!!!!!!!!

Do you think that in your area there might be a perinatal mental health care pathway as above? Here, the GPs are supposed to liaise with them about this sort of decision. I was told that taking ADs in pregnancy was "irresponsible" and then refused to take them when psych prescribed them and was really very unwell. Don't let them do it! You need to change practice if they take your meds away, it isn't worth it.

thats so sad to hear, the risk from untreated mental health can be far far worse than the effects of psychotropic meds, for gods sake, these people are meant to support you and give you all the info, good and bad, so that you can make a choice, not make you feel worse and then make you ill!!!!!!! it makes me so angry, its not difficult for the gp to find info out!!!
if you type in to google, mother and infant mental health services and include your area, it may come up with their contact details or you could look under your local health trust who should have details of their service. failing that be stern with your gp and if needed report them/put in a complaint. midwives should also have good sound knowledge of these issues and should have contact details for a perinatal psych specialist.

I've just had this conversation with my GP,she called me and said the nurse had asked her to call me,I'm on 100mg of Sertraline and finicky beginning to feel sane.
The conversation was full of tutting and heavy sighs and telling me (someone DX with anxiety!) about congenital heart defects,and how it would be my choice,whilst heavily implying it would be my fault if anything did go wrong.
She's written me a prescription for 50mg,and I'm supposed to collect it tomorow.
I'm so nervous as I still felt terrible on 50mg and it's only when I was upped that I began to feel better.
My depression and anxiety always gets worse in pregnancy and post natalely.
Is there any truth in what she's saying?!

Oh,and this is with a view to stop them altogether.

What would happen if I just didn't reduce,and carried on with my normal 100mg?
I'm really starting to panic.

Please don't panic. I would really see if you can get a second opinion from a specialist. General rules about anxiety apply too in terms of minding yourself - don't go googling, try not to seek lots of reassurance but take steps to productively problem solve (sounds like you need the 100mg, so go with that and make it happen, get someone more sympathetic).

The risks are stupidly small but GPs can talk out their bums about it - it's amazing how they are so keen on telling you all the side effects for "informed consent" when I've never been told equally serious side effects with other (non-AD) medication I've been on

Thankyou,that's really reassuring.
I don't want to go back to the place I was in last year,or the even worse place I was in when I had DC1.

What do you reccomened I say to the GP? She wants me to go in to see her next week.
Oddly enough,this is the GP that finally listened to me,and seemed competent enough to advice me on BFing whilst on Sertraline...shes always been nice,I'm not sure why she's being so adamant about this.