Restrictions on certain ADs for women of childbearing age

[Pekka]

This is a really interesting article, I do hope the professor has been misquoted. I would like to think HCPs don't share her point of view. ADs can be so helpful, I have seen that first hand.
www.telegraph.co.uk/women/womens-life/9631088/Women-of-childbearing-age-should-not-be-allowed-to-take-antidepressants.html#

They need to make sure they explain the risks before prescribing them. They are dealing with adults here, and shouldn't discriminate against women of childbearing age. I agree with edam.

I, like Brittaperry, would be very ill if it weren't for the medication I'm on. Can't do without it.

Oh ok, thanks - I read up actually and it said it was often used to treat bipolar/manic depression.

I don't know too much about it all, but surely that's a very different set of symptoms and needs than someone with simple depression?

and I can see that the drug the article talks about, and the subject being given as to do with ADs is kind of odd...I'm not sure which it is we're talking about.

Obviously people need drugs if they will become seriously unwell without them. If they have a pathological disorder, I mean it's obvious.

People with depression are often NOT in this category.

Therapy should be offered to all patients with depression. But even with therapy, some women with very severe depression would still need anti- depressants.

It is different overall, but the depression bit is still depression. I got prescribed lamotrigine when I was low, and one of the things I was beating myself up mentally about was the amount of people saying that mental illness is a capitalist construct/misogynist/a nutrition issue/just making a fuss etc.

My medication costs the nhs around £6 a day and I will be on it for the foreseeable future. It is not cheaper than a course of counselling.

I HATE thevstigma around antidepressants. I have borderline pd and was on antidepressants for almost 20 years - came off about 14 months ago having had serious psychological treatment, but that wasn't available for someone like me even 5 years ago, I was regarded as "untreatable".
I was on ads right through 3 pregnancies and 3 periods of breastfeeding (shortest a year). I had to research the drugs myself and ended up lying to my GP (with the knowledge of my GP dh!) to get the medication I needed!
What worries me is that people - including doctors- will read the headline but not the article. Most common ads are not contraindicated in pregnancy. SV is a seriously heavy duty drug used in severe cases needing mood stabilisation. Not an "antidepressant" at all!

As Cupcake78 said, they're talking about certain drugs prescribed for depression that have known risks for a foetus. Not all antidepressants.

What a terribly bady chosen headline - both in the paper and in Most Active on here .

Most AD can be taken in pregnancy and when BFing.
The risk of taking the safer ones when necessary is IMO much smaller than the risk of NOT taking them in seriously ill people.
FFS.

I think I am going to report this to MNHQ and ask them to change their title in Most Active - it would be terrible if anybody sees this, does not read the whole thing and stops their meds.
What do you lot thing?

I don't disagree with the article.

I believe that anyone suffering mental health issues should be given the best treatment possible whether drugs or therapy or both. That said if a particular drug that has potentially dangerous effects on a pregnancy is given to a woman of childbearing age and she accidentally gets pregnant whilst taking them then the consequences could be disastrous. Is it unfair to assume that women won't take the adequate precautions or understand the consequences of a pregnancy on these drugs? Is it unfair that a GP's primary may not fully explain the side effects of any drugs offered? In my opinion it is slightly unfair but it's also a reasonable assumption. You only have to watch one episode of Jeremy Kyle to realise that we are not all intelligent, responsible people, we are all fallible and accidental pregnancies sometimes occur in the most unlikley of circumstances. GP's are also performing a balancing act, someone with depression or a mental health issue requiring treatment may not be in the best position to fully appreciate a discussion of the side effects. My GP actively recommended I do not read the leaflet enclosed in my anti depressants because I was vulnerable and had been suicidal and it would have scared the life out of me. We had that chat a few weeks later once they'd kicked in and I was in a better place.

I think we live in a nanny state where we actively blame our government rather than take responsibility for ourselves so I don't think on the whole we can blame the medical profession for trying to eliminate certain risks and call it discrimination. It's not just politics it's also financial, is the possible pay out to a woman who becomes pregnant on these drugs and has a child born with serve disabilities or looses that baby higher than the cost of utilising a different drug for child bearing women?

agree with PacificDogwood the headline is misleading!

My sister took Prozac for both her last pregancies - the risks of not were much higher than the miniscule risk of any abnormalities.

I take Lamotrigine for Bipolar Disorder - I reduced the dose for the first 14 weeks and then went back up again. I also take large quantities of opiates for a spinal issue and chronic pain.

DD was opiate dependent at birth, but the neonatologists, pain specialists and OBs had all planned for this in advance - and she was never in any pain as she was treated straight away. We were in hospital for a week to make sure all was well.

Women and their doctors need to do as much research as possible and consider all the risks. With the access to information we have today I don't think much of people who entrust everything to their doctor.

I was recommended not to breast-feed as I was taking Lamotrigine. I went away and researched, spoke to the Epilepsy Society and to women on 3 and 4 times the dose I was on and breastfeeding. I made the choice that I would breastfeed as I felt that the benefits far outweighed the miniscule risk of SJS (which has never been seen in a neonate) considering the tiny amount that passes through breastmilk compared with the 100% that had been passing through the placenta.

I was told strictly off the record that I had made a good choice.

I agree with you, pacific dogwood

Good grief, Pyrrah, what idiot thought lamotrigine was a bar to b/f? Some hcps get very funny ideas in their heads indeed and often don't bother to check with people who do actually know about that field of medicine. I am aware that I am extremely lucky to have lived next door to a neurology tertiary centre when I developed epilespy, so that amongst other things when I became pregnant they were able to give expert advice to the midwives and obstetricians.

The real scandal is that ignorant/careless doctors dump women on sodium valproate or other teratogenic drugs without bothering to a. think b. consider if there are any suitable alternatives and c. discuss it with the woman concerned. SV may be the best option, but someone taking it needs to know that unplanned pregnancies are a very bad idea, and that when and if they do want kids, they may need to switch their medication.

PD I agree with you too (and I know you know what you're talking about!!).

Very bad headline and poor show to MN for copying it. I think I'll report my own post to flag it up to them!

I agree PacitifDogwood, it's a terribly misleading article with no useful information in it and the MN tag line just adds to the confusion.

As others have said, the only drug mentioned in the article, Sodium Valproate is not an anti depressant at all!

It's so annoying when journalists write shit like this. The potential side effects of sodium valproate to an unborn foetus are very well known and Pyschiatrists do routinely consider that when prescribing or not prescribing it to women of child bearing age. This is nothing new.

A pg woman is routinely offered a meds review
sodium valporate is an epilepsy drug not an AD
AD have a valuable role in maintaining good mental health and can literally be life saver

epilium licence is for epilepsy but its used off licence in treating mania too
but significantly if in doubt see your GP or psychiatrist,dont just stop AD
i wonder if Ms Howard has been misrepresented

I don't know why people are getting cross and slagging off MN for the thread title. HQ don't write thread titles!

Several anti-epileptic drugs are used in psychiatry as well as neurology. It is important to remind doctors and patients of the dangers of prescribing those that are teratogenic (or any other class of drugs that has similar effects) to women of child-bearing age, without a thorough investigation of treatment options and informed consent from the patient, so she is aware of the dangers and options.

For mild to moderate illnesses, psychological therapies are available and they would be first line.

Which would be all well and good if it didn't take a minimum of 6 months to get a first appointment for these on the NHS.

On my "discussions of the day" box it says "anti-ds - not if childbearing age?". MN certainly wrote that!
It's disingenuous as the article is about an epilepsy drug occasionally used for mood stabilisation. Or neurological pain.

And funnily enough I take an antidepressant for neurological pain!

Sorry for those who are offended by the title of this thread. I took it from the article, I should have added "certain" before the ADs. That would be a fairer representation of the article. I have nothing against ADs and I am not suggesting women should stop using them.

good to clarify that point
the anti meds lobby can create fear and guilt around taking AD
AD are a useful treatment, as are talking therapy and activity sometimes you need the AD to lift mood to be able to engage tolerate talking therapy

50% of pregnancies are unplanned? wow
I'm pretty sure they don't prescribe thalidomide to women of childbearing age now either.