Antidepressants and pregnancy - anyone???

[BritinUSA]

Hello - this is a post I hoped I wouldn't have to write. I thought I would be able to 'somehow' get through my (first) pregnancy and manange the hormonal roller coaster that it is.

A bit of background - six years ago I was diagnosed with severe PMDD (rather like PMS but worse). I was put on a low dose of antidepressant which helped tremendously to alleviate the symptoms and helped me to live a normal life (read, much improved relationship with husband). Prior to pregnany, I know my husband was really concerned about the effects of me coming off medication and unfortunately, all his worst fears have been proven to be correct. It appears preganancy hormones don't 'protect' you from imbalances you may have experienced prior to conceiving, in fact (and certainly in my case) they exacerbate them.

Speaking to my Obgyn, she has prescribed a low dose anti-depressant. I'm at 16+6 and everything I have read indicates the overall risks of taking the medication are low, partiucarly during the first half of pregnancy. But, I am completely torn. Risks are risks are risks and how could I live with myself if what I take now negatively affects our baby? On the other hand, my marriage (after four months of extreme symptoms) is taking a bashing and I am not sure how much more my husband can take. He is as supportive as he can be, but he has reached breaking point. It is just so very sad. This is 'supposed to be' a joyous time, and yet we fight all the time, I'm not sleeping and I can't see how things will get better. I'm under absoutely no pressure from my husband to take any medication, but I just don't know what to do.

Has anyone else had any experience of this? It's not easy to talk about, but I am really at my wits end. All I am hoping for is a healthy baby and reasonably happy husband. I am sure that is all anyone of us wish for. Any advice from those who might have experienced anything similar would be much appreciated. Thank you for listening.

Hi BritinUSA, I have no experience of antidepressants. Hopefully someone else can assist. But I just wanted to offer you a virtual hug and make two supportive points:

1. "Risks are risks are risks and how could I live with myself if what I take now negatively affects our baby?" We all take risks every day, in order to get by. Travelling by car is probably one of the riskiest things we can do, but most of us do it frequently in pregnancy. Provided you've discussed it with a GP and followed medical advice, I would personally suggest that taking antidepressents is worth the risk if it keeps you and your relationship on track.

1. "This is 'supposed to be' a joyous time, and yet we fight all the time, I'm not sleeping..." Lots of pregnant women find pregnancy stressful, scary, uncomfortable and/or confusing. All over Mumsnet you'll see pregnant women having a bit of a hard time with pregnancy. Please don't let the pressure to be "joyous" get you down even further - pregnancy can suck, but that doesn't mean you're not going to be a great Mum :)

Hi there,

Hope this reassures you...

I think it very much depends on the type of medication and your doc will help you out on this - mine actually got his 'manual' out to look at the exact wording- but in my case they hadnt actually proved any effects negative or otherwise, so they just couldnt make any guarantees.

I took my anti-d's all through pregnancy at a low dosage- 5mgs per day or 10mg every other day- with no adverse effects. DD is now a healthy 2.7 yr old:-)

Ideas:

• Talk to your medical team or pharmacist about your concerns; they'd rather give you evidence-based info than have you worrying unnecessarily.

• Try to keep things in perspective. Very little of what we do or consume or use in everyday life is conclusively proven to be safe in pregnancy. We could worry about shampoo, handwash, everything... evolution has you at a heightened state for possible risks, that's just natural.

• Antenatal depression affects about 1 in 7 women. It is that common. So you are in a large group of people, some of whom will be taking antidepressants, with many more having gone before you. Therefore your medical team have a lot of info available on the safety of individual treatments.

For any medicine, my advice would be:
Check the patient info leaflet, if it says "licensed for use in pregnancy" then it's gone through a lot of testing. Otherwise, it may not have gone through enough tests for the regulatory authorities to ok it (it can be difficult to arrange clinical tests of drugs in pregnancy) but will likely have been tested in pg women in real life.

As ladylay says - it depends on your meds. I took mine all the way through but gradually stopped towards the end as they weren't compatible with breast-feeding.
I hope you work something out

I was recommended to go onto a short course of antidepressants before Christmas (I was not coping as the due date of my miscarried twins came round); I actually decided not to as I felt what I was experiencing was natural grief, not depression (which I have suffered from in the past).
My GP used to work in obs and gynae, and, as we were TTC, did reassure me that the drugs in question were safe for pregnancy - I'm afraid that I can't remember what they were now. Perhaps give your GP a call and talk through your concerns?
Additionally, have you been offered counselling, or is that something that you would consider. It's not for everybody, but I have found it very helpful.
Good luck x

Sorry you are going through this, its a tough decision. I know its not exactly scientific evidence but I just wanted to offer you a story with a positive outcome. I took fluoxitine (prozac) when I was 18 weeks pregnant and everything turned out fine - baby born HUGE and very very healthy, he is 2 and a half now and very bright, active and inteligent :-)

Like you I read all the pros and cons and decided to go ahead even though there were no guarantees and i dont regret the decision, I sailed through the rest of the pregnancy quite happily. However, like you are being advised, I also had to wean myself off them before the birth so that I could breastfeed and did find the post natal period very hard. After a month I stopped breastfeeding and went back on the anti depressants. I think the post natal period is hard work for everyone but if you have a tendency to suffer depression then it is bound to be an issue then, so be prepared to have an open mind about breastfeeding. I became a much better mum when my baby went on the bottle.

Hope it all works out for you the way you want it to, good luck

Hello to you all - thank you so much for your insights, advice and support. Already looking at 'risk' in the way PipPipPip suggested is very helpful and certainly forces one to view the situation slightly differently.

WheresMyTeaCup, if I may ask, what dosage of fluoxitine were you prescribed and how long did you take it? My Obgyn has prescribed 20mg a day of fluoxitine. From my reading there is an increased risk of pulmonary issues for the baby if this medication taken is taken in the second half of pregnancy - but not sure what that means exactly.

Thanks again to everyone. Beedus, my heart goes out to you and I hope you are doing well, thanks for sharing and do hope you are feeling better.

A quick one - not read all the posts here.

I'm 37 wks now with my 4th and struggled with PND after the first two babies, and depression never really left me (I'd had a serious accident in '96 which triggered depressions). I was on a low dose of antidepressants when I fell preg with my 3rd and my GP told me to come straight off them. WORST thing I could have done.

This was 4 rs ago and I was climbing the walls within a week and one night I threw a framed pic at the bedroom wall (still has a hole in the wall!), went to the kitchen and put a carving knife on my wrist. I screamed at my husband for an hour, I was demented. All because I'd come off my tablets and quickly. He took me to the docs next day - different GP said the risks were v low and the risk to me of being off the tablets were worse than any risk to the baby. Within a couple of weeks I was back on track.

Re the risks: he said the only possible identifiable risks to baby were temporary jitters (I think) that would wear off within a day or so - ie nothing dangerous. And my little boy was born fit and healthy with NO issues at all.

I'm on the same tablets now as I was then and have been all through the pregnancy - and have not given it a second thought.

I hope that reassures you?! x

I have to take antidepressants at a low dose for pain relieving effects (amitryptiline 20mg per day) I am pregnant with dc2. The docs say that the risk to me without them outweighs any risk to the baby. When preg with dd1 I had to take an opiate through the pregnancy for pain relief. I was petrified of the damage to my baby & she showed definite signs of detox/withdrawal but although distressing they were shortlived . You can look on the net: NIHCE guidelines on antidepressants, there is lots f info there. Sorry for what you are going through, I suffer hideously with hormones too, its hard when it feel as though your mind & actions are beyond your control.

cherryteat and PermaShattered - thanks so much for sharing. I'm glad you are both doing okay now. Cherryteat, you summed it up perfectly when you said 'it is hard when it feels as though your mind and actions are beyond your control'. If one had a physical ailment it would be obvious for the world to see - what goes on with the mind is MUCH more difficult to manage.

Thanks again for your support and reassurance :)

Hi, sorry for the delay in reply. I'm afraid I cant remember the dose, but it was just one pill a day. Will try and see if its in my medical notes somewhere.

BritainUSA It was 20mg a day