Depression/OCD and unable to take meds due to TTC

[eqhelh]

I have a history of anxiety, depression and OCD. I’ve tried various medications over the years and the only ones that have really worked are mirtazapine and most recently paroxetine. This year we decided to TTC so I came off my meds, I fell pregnant for the first time in March but miscarried in April, we then fell pregnant again straight away but miscarried for the second time in June which required an ERPC.

Two back to back miscarriages have really taken their toll on my mental health. I’m depressed and my OCD is worse than ever. The problem is all the meds that the doctor says are safe to take during pregnancy, I’ve previously tried and don’t work for me.

I feel like I’m at a bit of a loss and don’t know what to do. I’m almost 35 and there’s clearly something wrong so I don’t want to stop TTC as I’m worried I’ll run out of time and the NHS wont help until I’ve had another miscarriage and then there’ll be referral times and waiting lists which god knows how long that would be but equally I’m miserable. I can’t face seeing family and friends, I cry all the time and it’s awful. I’ve self referred for CBT but there’s a 6 month waiting list apparently so I really don’t know what I can do to feel better in the meantime when medication isn’t an option.

I'm sorry to hear that you're struggling so much and especially sorry for your losses. In your shoes, I might consider taking a medication even though it hasn't particularly helped in the past as well as the ones you can no longer take due to TTC. It might lift your mood, even if it doesn't alleviate your OCD much. Your prescriber is obviously well aware of which medication can safely be taken in pregnancy.

When you say there's a 6 month wait for CBT, is this in England for Talking Therapies? If so, perinatal patients are a priority. Did you tell them your circumstances? If you've had previous therapy for your OCD, do you have a staying well plan that you can work on? Wishing you all the best 💐⁸

I'm sorry you are having a difficult time. I had two back to back miscarriages in 2024 but my third pregnancy a was successful.

There are medications that are safe to take in pregnancy, I would ask your GP to consult with a perinatal psychiatrist for prescribing recommendations in a woman TTC. They are more up to date on the risk factors for prescribing in pregnancy so there might be other options. They might be better placed to go through your history of the other mediation to work out which might be worth another try or discuss when medication can be given.

I'm bipolar and was on mirtazapine when I started discussing TTC with my psychiatrist. I was also on lithium and quetiapine. I was told the quetiapine was safe for pregnancy, I couldn't take lithium whilst TTC or in early pregnancy but I could take it in the third trimester. I could stay on the mirtazapine whilst TTC but not in pregnancy. I made the decision to stop the mirtazapine first then then the lithium as I was worried about the antidepressants sending me high. The plan was to restart the mirtazapine whilst TTC if I developed low mood, stopping after a positive test and if needed restart the lithium later in pregnancy. I have had pnd again and I'm now on quetiapine, venlafaxine and mirtazapine. We are weaning me off the mirtazapine as it's not been as help as it previously has been

How close to 35 are you? I had a referral to the reoccuring miscarriage team as I was over 35 they could do the referral after 2 instead of 3 losses. They also prescribed progesterone for the third pregnancy too. I don't think the progesterone was the reason that this pregnancy was successful and the others weren't as the two pregnancies I lost never made it passed 6 weeks gestational age and I was 8 weeks pregnant when I had my first scan in the third pregnancy and started on progesterone at this point - I didn't know how far along I was as I hadn't had a period in between.