Anyone been on Anti Depressants whilst pregnant and/or breastfeeding?

[pie]

As some of you may know I have been on ADs for the last 5/6 years except when I was pregnant and b/f DD and now, as I am pregnant again.

All my doctors, when I found out I was pregnant, said that if I could then coming off completely was the best thing to do. So I did, in 4 weeks I was completely off Venelafaxine, when the recommended weaning time for my dose was bout 6 months.

But I think that it was too soon and too fast. My world is crashing down around my ears and I'm terrified that someone will try to admit me to a psychiatric unit.

I saw my OB a couple of weeks ago and mentioned this, she said that in retrospect I could have stayed on the AD though I would have been advised to come off when b/f. As I only have about 11 weeks left till my due date, there was no point putting me back on as by the time the pills started to work I would have to come off again.

So my question is this: has anyone here taken ADs whilst pregnant and then stayed on them when b/f. If so what were you prescribed? I would like to go to my next appointment knowing that I may have opitions other then some sympathetic look and another psych appointment 4 weeks down the line.

TIA

Pie, you could speak to susanmt, i believe used Lustral whilst pregnant and b/f, you could check this earlier thread on PND as it has references to Depression during pregnancy as well.

have a look a this

HTH, I had antenatal depression during my first pregnancy and it was awful,it was not caught, i did not know anything about it and could have really done with some help then.

Pie, I don't know about the SSRIs but I do know a bit about tricyclic antidepressants. No-one can advocate that you use ADs in pregnancy for the simple reason that there are no clinical trial that prove that they are safe (you can't do clinical trials on pregnant women for ethical reasons). I do know that women have taken Dothiepin in the first trimester and that the manufacturer is not aware of any pattern of abnormality in the foetus, or any increase in foetal abnormality linked to it's use. They advised that the mothers be withdrawn towards the end of pregnancy, incase any medication was needed at the time of delivery.

Regarding use while bf. Dothiepin in secreted in small amounts into the breast milk however small studies have been carried out on the long term developemnt of the children and no adverse effects were identified. In fact there was some cautious comments that the children may have done a lttle better than if they had been with a mum with untreated depression (IYSWIM)

For more info have a look at Breastfeeding and psychotropic drugs

hmb, thanks for the link. I can't take tricyclic AD as they induce psychosis in my, fun huh?

I have seen Lustral referred to on a couple of other threads, is this the preferred drug for pregnant or b/f women?

I don't think that NOT seriously tinking about medication is really an opition for me as before I started taking ADs all those years ago I tried to take my own life 4 times....those feelings returned when I was off ADs to b/f. I really want to b/f this time again, it gave me such a sense of achievement and closeness.

Ranting now!

I don't know about Lustral, I've never worked on the product. I hope that you get things sorted out to suit you best. Do you have a good relationship with your midwife of doctor? Could you have a chat with them about this and get some support?

I hope things go well, take care.

hmb, I have a good relationship with my GP, but never see the same psyhciatrist or m/w twice, guess its the nature of big hospitals?

I see her next week so will talk to her, though she is ultra cautious so I thought that if I had some info I could have a more informed chat.

I just don't want to spend the rest of this pregnancy like I did Saturday night, crying, unable to breath and knowing that the only things keeping me alive are DD and the baby growing inside of me.

Pie - have you thought about the Dalton Regime to combat PND? I suffered (and am suffering) pre-natal depression, the last time round I was too late for medication, but as I was a very high risk for suffering PND they gave me progesterone treatment straight after birth. This consisted of an injection every day for 7 days, and then suppositories until the first day of your period. I also breastfed. It's just an alternative to think about.

If you are going through what I am at the minute, then my heart goes out to you. I decided against medication this time (although it's still there if I want it), and the GP has referred me to a CPN and is also sending me a CD ROM entitled 'Beating the Blues'. Lots of support is needed. I know this last weekend I was tempted to stay in bed, with the covers over my head, and just die. It took a lot of energy, but I managed to get myself out of bed and I went to the park with dh and dd. Just a small step, but it did make me feel a whole lot better. However it is SO hard to do as facing the world is the last thing you really want. Feel free to contact me, but I totally understand if you don't. I find it very hard talking about it to anyone.

Hope you can find a solution soon, you have my very best wishes.

Thanks for the lovely message Rhubarb, I've been a diagnosed Clinical Depressive for 10 years, so I'm not sure it is so much related to PND or pregnancy, but rather my on going condition. On the other hand maybe a PND approach would help more at this stage than treating it as my 'usual' state of being. I will ask my doctor about the injections you mention too.

I read your message on the other thread and am glad to hear that you are fighting back. Its so hard when people are expecting you to be 'glowing' and as you said you just want to hide and die.

Please take care xxx

Pie - I was diagnosed with clinical depression in 1988. Since then I have been on and off medication and in and out of therapy.

After the birth of my son in 2002 I hit a very bad period and my psychiatrist proscribed the SSRI, Citalopram. I sought a second opinion and was told that citalopram was considered to be 'OK' to use in breastfeeding because no side-effects had been noted in the b/fed children of mothers taking citalopram over the past X years that it has been available.

What made more of an impact on my decision to take the drug was that both psychs. suggested that the risks would be greater to both ds and I were I not to take the medication - the level of depersonalisation and detachment I was feeling at the time were something else.

I can't say that I would have wanted to take the medication whilst breastfeeding but I can say that to date it does not have appeared to have had any effect on ds whatsoever. He is a happy, healthy, normal little boy developing at exactly the right rate.

I am so sorry that you are going througn this difficult time. Discontinuation of meds is a dreadful thing and I can't imagine what it must be like to do it whilst you are pregnant. My hat goes off to you and I wish you all the very best.

Good luck.

This has been worrying me since I found out I was pregnant. I have been on ADs for 13 months which have taken me from the worst place I have ever been, back to my "normal" self again. At first I thought I would be being weak for taking them and resisted even seeing a Dr about my depression for months because I didn't believe ADs were the right way to combat it, or that the Dr would laugh me out of the surgery.
When I finally did go, the Dr I saw was wonderful, explained my options to me and let me make up my own mind about what to do. The plan was to come off the ADs a few months before trying to conceive (it didn't happen that way) and I got myself in a right tizz about what harm I was doing my baby, so I stopped taking them without advice, convinced I was doing the right thing.

Within 2 weeks I was a wreck, the shock of the unexpected pregnancy, the withdrawal symptoms and the stress of my upcoming wedding turned me into a horrible person to live with (it's a wonder my poor husband to be even turned up at the wedding!). The Dr soon realised what was going on and put me back on them. I can't breastfeed which is a shame as I would have liked to do that, but she made me realise that a healthy baby depended on a healthy mother and if I was depressed and miserable I wouldn't be giving my baby the best start in life.
There isn't much research done into ADs during pregnancy, and because of this no drug company will say their product is safe to use. But I am of the belief that I would be doing more harm than good to myself and baby if I were to go cold turkey again. My aim is to get off the ADs asap after the baby is born, avoid possible PND and get back to my ususal self.
There is a huge stigma attached to drugs during pregnancy, which I was guilty of buying into before I was in this situation. None of my family know about this, not even my closest friends, just my Dr and husband. I am very lucky in that I have a very loving and understanding husband and hope that everyone else out there who is in this situation will feel less guilt about being in this situation.
Research shows that people who are on ADs for 18 months + before coming off them have a better recovery rate than those who take them for less than a year, so with any luck I can say goodbye to them by the end of this year. Sorry this is sucha long post!

Hello,
I just posted a similar thread under the parenting discussion.
I suffered from antenatal depression from about 15week pregnant. I have never suffered from depression before but I became very tearful, anxious, I had no motivation to do anything and became clingy and unsettled about my future with DP. I convinced myself that I was such a horrible person he would leave me. I thought my family and DP would be better off without me. I started to resent being pregnant and no longer wanted the baby (god that sounds so awful now) I went to the doctors in desperation and he perscribed prozac(fluoxetine)I have searched for hours on the internet and have found some studies that show there is no increased risk of major deformities. The only evidence against taking it is that is seems to cause babies to be irritable, jerky and a low birth weight. However follow up tests reveled that they soon caught up and suffered no ill effects. I was taking 20mg per day for 2 months. Since about 26 weeks pregnant I have taken 20mg every other day. I have tried to come off the AD's but started to get OCD and was convinced that everything I did/had done was causing harm to the baby e.g I wouldnt eat chicken encase of food poisoning and would wash my hands constantly. I am now back on 20mg every other day. I went to see my doctor yesterday as I am due in 2 weeks time and know that prozac is not suitable for breastfeeding. His attitude was no ADs are safe and that my options are to either continue with the AD and bottlefeed or come off the AD and then breatfeed. I found him really unhelpful. I have asked my MW today and she is going to speak to someone for me. In the meantime I am now trying to come off the ads within 2 weeks to prevent the baby from having withdrawal symptoms and allow me to breastfeed unless my MW finds a alternative. I really hope that I can finish taking ADs and admire you for having not taken them throughout your pregnancy.
Sorry this is such a long story but I hope it helps you.
Take care

there's got to be some that are safe to take - I have been told by my gp that I can keep taking amitryptaline (sp) whilst pg/bf. I take them for insomnia/pain relief but know that they can be used as ads. Good luck in finding something to help, have you tried any alternative therapies that may help?

just found something on the babycentre website. Someone asked the question is prozac safe and the response is quite good.

I didnt get the link though sorry.

KBaby, sorry if this advice comes a bit late!!!
I was in a very similar situation to you, (even down to the handwashing/food paranoias), and on 20 mg Prozac every day. I was told by the obs/gynae consultant and psychiatrist (who double checked with a pharmacist) that it was fine to breastfeed on Prozac - there has been recent research that shows although there are traces of Prozac in the breastmilk, this does not have an effect on the baby. Also I was told by the psychiatrist that it would be better to breastfeed than not, as this would reduce any withdrawal symptoms the baby might get after the birth, since he would not be getting his daily dose of Prozac. GPs tend to be (quite rightly) cautions about ADs and pregnancy. However what they are not good at is referring you on to psychiatrists or somebody who does have the knowledge/confidence to prescribe these to you. My GP wouldn't refer me to a psychiatrist as "he would only recommend you have counselling anyway" -thank god the ante-natal care was fantastic, and sorted me out a referral to a psychiatrist.

Related question: my consultant has raised the issue of my depression having an adverse effect on baby's pre/post birth weight (now 29 wks) and wants to to do regular scans to keep track - tho my understainding is that there's nothing to be done for the baby in any case. I'd rather avoid un-necessary scans/more anxiety about weekly foetal weight gain, unless there's actually something helpful that cd be done. Any experience/ideas??? Not at the anti-depressant stage - yet - thankfully.

Only you know how bad your depression is, and from the sounds of it you have, like me, very severe life threatening depression when not on your medication. I am surprised that you have been told to come off your medication. I see a consultant obstetrician at Queen Mary's here in London and a Psychiatrist at the South Maudsley Hospital. Both are leading hospitals in there respective fields and both doctors have advised me to keep taking my medication throughout my pregnancy believing a return bout of depression would be more detrimental to me and my baby.

I took Seroxat 30mg throughout my first pregnancy and during breast feeding. My 6 year old son is thriving. My only problems have been when 3 years ago in an attempt to be medication free for a 'perfect' planned second pregnancy I came off the Seroxat and ended up severely depressed, suicidal and needing Electroconvulsive therapy. It has taken me 3 years to get back to full health and embark on a second pregnancy.

You need to make the best decision for you and your family. I know how utterly disruptive a bout of severe depression is on a young family, as must you. You need to weigh that cost up against the slim amount of evidence about antidepressants taken in pregnancy. It is not the perfect drug free scenario that we all dream of for our pregnancies but I for one thank god that I am here to have such a dilemma and that is down in most part to the drugs that I take.

From what I have read online, the concerns about your antidepressant are similar to mine. But generally any drugs side effects in pregnancy are unknown because you can't set up significant studies involving pregnant women and medications, it is unethical. The medical profession have to err on the side of caution.

Here is a study you may find helpful... ttp://ajp.psychiatryonline.org/cgi/reprint/158/10/1728.pdf

I wish you all the best babe xxxxxxx