imipramine, pregnancy and more specifically breastfeeding: leaflet says don't

[pecanpie]

I've just been prescribed it but the leaflet says don't take if pregnant or breastfeeding. Dr says I will have to stop taking a few weeks before baby is due to prevent withdrawal symptoms, but otherwise as I'm in 3rd trimester no problems taking it. I was expecting to breastfeed though as I did with my DD, but am concerned now that I won't be able to. Problem also that I will have to change doctor as private only covers 6 months and pretty much will have to switch to NHS for PND avoidance/ general maintenance of current care at exactly the same time as I'm due which scares me a little bit because I'm worried that I'll get lost in the system and won't be able to cope. I know now that I absolutely need the help now and will need the help going forward and the NHS hospital where I am having the baby has been great so far (Royal Free. Does anyone know anything about psych follow up there and potentially have any names of consultants I could be under?

Thanks to those who responded to my previous thread - now I actually have the medicine I'm just a bit more stressed out by the potential side effects - like what happens if I get any of them, do I just stop taking and then what would my options be and what is the affect on the baby long term.

Further reassurance would be HUGELY appreciated.

hi pecanpie, i don't know anything about imipramine specifically, but i do know there are plenty of anti-depressants that are fine to take whilst breastfeeding so it's really worth talking to your gp about alternatives.

tbh i have found (from experience) that you're actually much better off getting a prescription from a psychiatrist or someone with a better knowledge of the individual drugs. GP's are fab, but they don't necessarily have the knowledge of specific drugs that a psych for example, may have.

I would also find out about nhs mental health services now, for after the birth.
here we have what's called the "maternal mental wellbeing" service, which i have been referred to before. you basically have an appt before baby is due, and then you can either keep going, or just arrange to see them after baby is born, or whatever you feel happiest with

if you open the pdf here (anti-depressants one) it mentions imipramine

Imipramine - has an active metabolite, desipramine. At therapeutic doses it is estimated that
the baby would receive 20-200mcg / day and no adverse effects have been noted. It would
be prudent to observe the baby for sedation and dry mouth

here and www.netdoctor.co.uk/medicines/100002601.html and here especially all suggest that although it does pass into the milk and should be used with caution - it is not known to be dangerous to BF while on this medication. The last link actually specifies that it is one of the safer drugs when breastfeeding, compared to the alternatives.

this is from the breastfeeding network - they also seem to feel it is relatively safe. I would discuss it further with the doctor - few if any medicines will state they are categorically safe during breastfeeding due to lack of trial data. hth

Thank you all. Thisisyesterday prescription was from a psychiatrist which makes me a bit more confident, it's just knowing that the position on ADs and other medication I'm taking is advised against unless benefits outweigh risks. I guess I'm just giving myself more to worry about.

Thanks for the bf info moaningminnie - I just want to be sure I have the choice before I start taking the pills properly.

moaningminne have now read the bf info in detail. Thanks so so much for the link. Feeling much better about having the choice and feel like I made the right decision when I was given the choice between SSRIs and TCAs. Apart from potential weight gain, definitely sounds like the right choice for me. Phew. Seeing consultant's team tomorrow am so I hope they will set me up with the post natal psych team then.

You're welcome

The BfN leaflets are written by a pharmacist who specialises in drugs and BF. I would trust her word.