Trying to conceive while on antidepressants (Prozac)?

[siandjess]

I have a close friend who has been suffering with anxiety and depression for over 10 years. In the past her illness has been controlled while taking fluoxetine (prozac)but now she desperately wants to try to have a baby. Whenever she tries to reduce her dose of antidepressant she relapses and becomes anxious, depressed and not like herself at all. She has been told to come off Prozac before trying to conceive but I have done some medical research for her and cannot seem to find any real evidence that it increases the risk of having a congenital abnormality more than 1% (and that figure was for another antidepressant of the same type, not even for Prozac itself).

I just wonder if any one else had this experience and could help. Does she stay on the tablet for her own sanity but then fret about the risk to her baby, or is the risk too high and she should just suffer with this debilitating illness? I just can't imagine it will be beneficial for the baby to be conceived when she is in such a state and whether it would be better for her to keep herself healthy while risking the very small risk to her baby (e.g. like any other medical illness like epilepsy or asthma). Any advice would be greatly appreciated.

Here's a response to that question from a midwife

I can't offer any solid advice as i'm on Imipramine rather than Fluoxetine, but i think the general feeling is that its more sensible to take AD's through pregnancy if you need too, rather than suffer.

A chat with her GP or a midwife would put her mind at rest, and if its necessary the GP would prescribe an alternative suitable AD.

You're absolutely right - it won't be beneficial to the baby if she is suffering so badly. After all, having a baby is such a huge thing that she'll need to be as well as possible before the birth. There is an increased risk of PND if you have a history of depression - so having it under control beforehand is definitely the right way to go.

Good Luck xx

Is there any chance she can be 'moved' to a safer AD? I needed ADs while pregnant (although I cannot remember what they were) and GP said they were about the safest (def. not prozac). It's a tough situation to be in... I presume she has talked to GP or a mental health worker?

Yes, she has spoken to her psychiatrist who has told her that she should try to come off the ADs but I just don't see how this is good advice as she is really suffering. Rough situation, but I can see from previous threads that a lot of women stayed on their AD during pregnancy w/o problems, but most of them seemed to have been on citalopram. Maybe will do some more research on citalopram to give some more advice I guess.

her psychiatrist ought to be able to tell her what the safest and most appropriate anti depressant for her is.
some may be safe, but not suitable for her symptoms, so you can't assume that because others have been prescribed citalopram that it would work for her iyswim?

fwiw I came off my ad's when I discovered I was pg with ds and I never felt better in my whole life- I guess I was just lucky that my pregnancy hormones seemed to make me feel better.

as an aside- perhaps she should think about having some more forms of therapy before tryting to conceive so that maybe she can get out of the depression once and for all?
anti depressants are fine, but they only treat the symptoms, not the underlying cause.
obviously I have no idea of her history or what treatment she has had/is having, but things like cbt can be very helpful and may aid her in coming off the ad's, or at least lowering the dose

hi.i was on prozac when i got prg with dd3.i was told to come off it for the first 12 weeks,which i did.i was offered an alternative but i decided to try without.however,i ended up with ante-natal depression and went back on prozac at 12 weeks.dd3 was fine(she is 5 months now).

i was also on prozac from week 20 when prg with dd2,and she was fine also.

i did read that it only causes problems if taken in the last trimester,but my gp was adamant that the risks are higher in the first 12 weeks for some reason.

fingerwoman makes a very good point also,about therapy.from what i know of psychiatrists,they seem to have the attitude that ad's are the only treatment for depression,but councellors and therapists seem to see them as something to get you to a place where you are able to deal with things.

You are so right. I have been trying to encourage some form of cbt, but friend tells me that psychiatrist did not recommend or that she felt that she was no ready for it or something like that. I think cbt is a brilliant idea, but alas, I probably don't know her full history (e.g. if there are aspects of her depression that the psychiatrist feels would not benefit from cbt or that maybe her psychiatrist is one that is keen meds only.... don't know!)

at the end of the day she has been suffering for over 10 years. anti-depressants may make her life liveable, but does she really want to be on them forever??
maybe wanting a baby will make her think about this a bit more- that perhaps there is an alternative?

You are so right. I have been trying to encourage some form of cbt, but friend tells me that psychiatrist did not recommend or that she felt that she was no ready for it or something like that. I think cbt is a brilliant idea, but alas, I probably don't know her full history (e.g. if there are aspects of her depression that the psychiatrist feels would not benefit from cbt or that maybe her psychiatrist is one that is keen meds only.... don't know!)