Can anyone advise on antidepressants?

[GMtoBe]

I have had PND for over 10 months. My daughter is 1 next week.

I had PTSD following her birth and have had an OCD diagnosis 6 months ago. I have been having a mix of CBT and talking therapy and have dealt with the PTSD well and am continuing to work on the OCD.

However, the PND just isn't going. It seems to improve and then I suddenly feel worse again. Tonight I feel that I'm almost at my lowest ever point.

My daughter is a poor sleeper. I'm still breastfeeding her and have no intention of stopping. I know sleep deprivation makes my PND worse. I'm finally considering antidepressants after nearly a year being adamant that I won't take them because I'm scared of the side effects. What I'd like to know is will they still work if I continue to be sleep deprived? How long will they take to work? How easy is it to come off them again? What side effects am I likely to experience? Thank you in advance and sorry for all the questions.

Hey. Sounds like you're having a really tough time. With the caveat that I'm not a medic, when I was in a similar position to you, I was prescribed Sertraline. My GP said it is the one antidepressant that can be prescribed to breastfeeding women.

I took it for about 18 months. Everyone's experience of these things is variable - some people find meds are a lifesaver, others find they don't do much for them.

In terms of how long they take to work, anything from a couple of weeks to a month or so. They will probably start you on a low dose with a view to upping it if you don't feel any benefit. It can be upped some way - I started on 50mg Sertraline, which was upped to 100 and then to 150mg (it can go up to 200).

I had some side effects such as feeling sick and headaches in the first few weeks but this is normal and passes for most people. If you don't like the side effects, you can stop, or discuss with your doctor whether it's worth powering on through.

Some people have a harder time than others in terms of coming off them. I would say that if you come off meds from an established dose, you should do this in consultation with your GP and do it gradually - don't come off cold turkey! I was on mine for 18 months and weaned off gradually; some side effects but nothing major.

What I would also say is that meds normally work best in tandem with therapy and other measures (eg getting out and about, finding other sources of support or things that make you feel good, exercise) - so it's great that you are already receiving some help and meds just might make the difference.

Good luck, whatever you decide

I take Amitriptyline. I was told it does not effect breastmilk to the extent it would effect my baby.
Ive found it really helpful as it really dealt with my difficulty sleeping in between feeds. It makes it very easy to fall and stay asleep but you can still wake up if baby cries.
Just dealing with my sleeping issue did wonders for my PND.

I had to ask for it specifically as it is not used as an antidepressant now days... it used to be but was replaced by SSRIs... its used to treat nerve pain now days.

It has really worked for me for PND though so I highly reccomend it.

oh and as for coming off it: I have only ever been on a low dose of 10mg so it was very easy to come off it at that level.... I just took it every other day, then every few days and then just stopped. I was on it last time for 6 months after my sons birth. I have been on it for 3 months now after my daughters and I intend to stop at six months like I did last time as that worked for me.

I also take Amitriptyline. Like the PP I had to ask for it, actually I had to downright insist on it and it was a psychiatrist who finally put his foot down with my GP and said I could trial it. It's very old fashioned, more commonly prescribed in very low doses for nerve pain and there are horror stories of it's side effects but I've had none. A bit of mild dizziness for the first couple of weeks but that subsided. The more modern SSRIs that supposedly are better and have less side effects have been a long list of sickness and headaches and hallucinations and a few suicidal episodes. If you don't get along with one drug, don't be afraid to ask for another and ask for something specific if you read about it and think it will work.

Don't be afraid of side effects. They usually don't last long and if you are suffering with them then you can come off quickly. I didn't stay on any one of them for more than 3 months and all but one, I stopped cold turkey with no ill effects. It's when you've been on them months and months you tend to have to come off them slowly.

Thank you everyone for your help and advice. It's helpful to hear about your experiences. I'm going to go and see my gp this week.

If you want to know more about Sertraline, there are lots of long threads on here - will give you a sense of people's experiences. Some people find it very effective - unfortunately I wasn't one of them but that doesn't mean it wouldn't help you.

I have another question. Is it true that antidepressants will just make me feel numb? I'm worried about not having good days either and just feeling nothing. Thank you.

Hi they can make you feel numb, but for me that was much better than teetering on the edge of a very high cliff
I agree with you too.....sleep deprivation is an absolute mindfuck
Good luck - you will get through this x

No. They can do that but usually if that happened you would change to something else and that particular medication would be considered not suitable for you. There are dozens of antidepressants and most people will find at least one that they can live with, even if not one of the mainstream ones. I just feel like myself on Amitriptyline, albeit a bit more chilled out and less likely to take things personally. Bit more of an even keel, emotionally.

Paroxetine was a disaster for me. I swung wildly between being downright chirpy and being weepy and suicidal. To be fair, I was weepy and suicidal before I started. The idea is to stabilise you so you can cope more normally, not to make you numb to things.

I took them for about 3 years following a bereavement. I was suffering badly with anxiety and depression. My advice is don't expect a quick fix. They can take a min of 6 weeks to start working, during those weeks you can often feel worse. I also found the first type I had did not help and had to switch to a different type. This meant weaning off them. But once I got the right ones I think they helped. I would say they took the edge off. I think a mixture of lots of rest and talking therapy was the answer. Rest is hard with a 1 year old. But the counselling was brilliant. I paid for a private counsellor as the nhs cbt didn't cut it. I think this saved my life. I do think if you can get some sleep you will feel better. I praise you for breast feeding, but if you are suffering could you give yourself a break? Perhaps express so someone else can bottle feed your baby? I only breastfed for a month, it was so hard as my girl wouldn't stay on my boob. I can really relate to the exhaustion during this period. I gave it up because I could feel my mental health issues creeping back and felt me being healthy, happy and able to look after baby was more important. I felt such Mum guilt after, but it was best for me and my baby. Could you put your girl in nursery for a couple of afternoons a week? So you can get some sleep? Do you have any friends or relatives that can help for a couple of hours? Or maybe hire a mums help for a few hours a week just so you can catch up on sleep? I think sleep is the key, then if you still feel low try the antidepressants. They aren't that hard to come off, it took me 6 months of slow weaning. I had some brain shake but that was about it. But it's important to say I was feeling a lot better when I decided to come off them. Good luck with whatever your decision is, it's hard being a mummy but you sound like your doing a great job xoxox

I took Citalopram for a year after being diagnosed with PND. Best decision I ever made.

Only side effect I had was in the 24 hours I felt really panicky. I called the 111 and the loveliest doctor explained that it was a serotonin surge and it would subside and to half my dose which I did and honestly the next day I felt a small chink of a calm mind. Took about a month to really sort me out properly but I wish I'd taken them sooner.

Good luck