Antidepressant use in pregnancy for anxiety, your experiences please xxx

[georgethecat]

hi, Am preg following a miscarriage earlier this year, have been a long term user of paroxetine got it to a low dose (10mg) and live a reasonably successful life, career, social life etc. Pregnancy seems to send me completely mental chicken oriental - major genralised anxiety. Two months ago whilst preg GP and MW were cool about this low dose and now following MC are angling for me to come off it, was even told by GP that it was my way of avoiding life! (although how I got to the level in my career by avoiding life, I don't know :) I was given a script with a you make the decision. I'd like to talk to people in the same boat or have past experience of MH issues in pregnancy. Please no judgementals xxx

There's a really long thread here about citraloplan in pregnancy if you can find it (it might be a few pages back) that talks about a lot of peoples issues.
Not sure that was the MOST helpful tihng of your GP to say.. you're hardly avoiding life (and its stresses by choosing to have a baby).
My GP (and the specialist she referred me to before ttc) said I could spread by does of AD but stay on them during pregnancy.. I can't cope without mine at all and have been taking AD for 13 years now. It is well accepted that I will NEVER stop taking them.
Also I'm 21 weeks pregnant so take that worry that the AD caused your MC and flush it down the toilet (I might have read between the lines too much .. sorry!)

good luck, and do ask specific questions if you want more answers.

katy

I fell pregnant last year and literally spun out. I was so anxious and depressed I almost considered suicide. My DH and I saw a psychiatrist and I asked for a termination (I was only 5 weeks). She put me on antidepressants (I was last on them 5 years ago). It turned out not to be a viable pregnancy but the hormones had sent me over the edge. I am now 23 weeks pregnant, on the meds and have never felt happier. I am seeing my psych every three months and she will assess me - but the plan is to stay on them and just monitor the baby when she is born. I have done a lot of reading how anxiety during pregnancy can affect the baby in other ways (ie make them into anxious little people) and the feeling is a well and happy mom makes a well and happy baby. It's a personal decision, but I would not feel pressured by the docs. They are being cautious because in some cases its been shown it can cause breathing issues at birth (but I think this is only if you take them in the third trimester). Do some reading/research of your own. good luck

wanted to add that it very much depends on what meds you are on. I am on cypramil/cypralex

What a thoughtless thing for your GP to say OP.

I went on ADs (sertraline) at 12 weeks for OCD and anxiety. Agree with Africa that a happy mum makes for a happy baby. There are no reliable studies out there showing whether ADs are harmful, and there never will be for ethical reasons.

But there's plenty to suggest that high levels of cortisol aren't great for foetal health or for mother baby bonding at birth.

My DD was absolutely fine - monitored at birth and I was supported really well by mw and cmht.

Sertraline made the world of difference to me, without it I wouldn't have coped.

I was on quite a high dose of anti depressants whilst pregnant with dd and she is absolutely fine, no adverse affects at all.

I don't have direct experience but from indirect experience I would say it's a good idea to be very careful about coming off anti-depressants and I personally wouldn't do anything in a hurry. If you were to choose to stop taking them it would be a good idea to have proper support and input from your GP (who sounds a bit rubbish, can you see another one?) rather than just having to get on with it on your own.

If the MW and GP can't give a specific reason to stop taking your medication, and have left the decision up to you, that sounds to me as if there's no reason to think it will be harmful to your pregnancy.

Many congratulations and best of luck!

I also had sertraline during pregnancy and bfing Ds2, who is now 7 and G&T with no effects whatsoever. I was on them because after many mcs the pg hormones were sending me into a bit of a spin, and combined with losing his twin during pg and the hospital handling it very badly, my head was in quite a muddle for a long time. The ads let me be a decent mother to my children. It worked for me, fwiw.

I took citalopram throughout both my pregnancies, and citalopram plus Lithium through my last one, and DD1 and the twins are all fine.

It is a case of balancing the risks or possible risks of taking them and not taking them.

Ask the GP to get an opinion from the local hospital Pharmacy department about the suitability of paroxetine in pregnancy, and I'm sure the answer will get them off your back. GPs are not experts in medication in pregnancy, whatever else they are. I'm sure that your miscarriage was nothing to do with it; I have never heard of any link between SSRI use and miscarriage.

Congratulations on your pregnancy and I wish you the very best of luck with it. If you have any other questions I am happy to try to help, ADs and pregnancy is a pet subject of mine.

There is a web site called mental health in pregnancy by the royal college of psychiatry you might find usefully, you should find it if you google it, I don't have Experiance of being on antidepressants while pregnant but I have been on antidepressants in the past for anxiety and I have done two of the 3 years training to become a mhn, if you have had envolvment with mental health services your doctor should have referred you too them now your pregnant, if you haven't it might be a good idea to ask to be refered to a community mental health team they will be the ones best to advise you . You are on a very low dose now but you really need some one to talk over the pros and cons of stopping the meds, this can depend on how ill you have been in the past , for some people the benefits of staying on meds out way the cons both for you and your baby, if I was you the first thing I'd do is get another doctor ! Congratulations and let us know how you get on

SPEAK TO YOUR DOCTOR ASAP.

I was on Lithium, lamotrigine and propranolol which all carry high risks in pg. My doc wants me to go back on lithium and start Quetiapine, but it needs to be strictly measured and controlled by them - incl regular scans and blood tests.

You are putting a chemical into your body, which will also go into the babys body. therefore it needs to be checked by the professionals - we have been very lucky (thouch wood) that so far there is no damage showing to te baby, but the lithium especially is very dangerous and could have caused a miscarriage as it messes with the babys organs so much.

As soon as I found out I was pg I was banging down the doors of my GPs to get advice re:medication. I'm now seeing a Consultant Perinatal Psychiatrist regularly, have a Perinatal CPN whom I see weekly, a midwife who specialises in mental health and under watchful eye of a consultant who specialises in fetal heart defects- this was all arranged a week after I saw the GP, and I had a scan within the week aswell - have scans every 4 weeks or so, plus a 'regular' midwife. It's not worth the risk waiting - it's v.v.v.v.important to find out everything- I also downloaded a copy of the NICE guidelines for info about babies who had been exposed to Lithium in the uterus. The first 12 weeks are the most critical, s othey might advise yo uto do what I did - reduce the dose with aim of stopping for the first 3 months, then go back on later in the pg once the babys organs have grown.

I stopped the AD while pregnant for the first 3 months after that was told it was safer.

I took one then I couldnt take it again too worried.

Im trying to manage symbtoms by taking it easy, seeing friends and not doing too much.

Im lucky that I can cut my hours for work down.

You have to do whats right for youxxx

My gp advised waiting till 12 weeks to go onto citalopram as my anxiety levels rocketed. I stopped the 3 weeks before giving birth and started them again the week after giving birth. Dd is absolutely fine and will be 1 next week. My gp felt having a low dose of anti-d made me calmer therefore reduced the effects the anxiety could have had on her. I'm sure on 10mg the risks aren't to high. Enjoy the rest of your pregnancy. Your gp sounds very rude.

Your GP is a sausage-head.

I am 17 weeks, and am supposed to be on sertaline. I'm not taking it as it has made me violently sick. When I was PG with my DS, I was on my darling fluoxetine. DS is absolutely fine. Bonkers, but fine.

I also go nuts when PG. Had a break-down in PG1, which was because I was taken off fluoxetine abruptly and left to cope alone with depression. This depression turned out to be bi-polar type 2, with anxiety and agrophobia thrown in for good measure. I found a wonderful GP who put me straight back on the fluoxetine, and my psychiatrist gave me diazepam up until 36 weeks. After DS was born, my psychiarist prescribed valporate and quitiapine. I was pretty much unconcious for 3 months while I got over the break-down and adjusted to the meds.

I had a mc last aug. I had been taking fluoxetine. But I am pretty certain this was not the cause of the mc. I am going to ask my GP next time I see him if I can't just go back to it, I don't know why they are messing me around.

See another GP. Don't let them mess with your mental health, you know what works for you and don't let them tell you otherwise. Good luck!

I am taking Fluoxetine with the full backing of my GP and Consultant for anxiety. It is really the only way I would cope and they both say stress is worse in pregnancy than taking the med. See another doctor.

In my second pregnancy (1st was a MMC) I went cold turkey on my AD's the moment I found out I was pregnant and I really dont advise it. It was awful. Luckily, although I had high dosages, they had short half lives. But oh my, everything see sawed for a couple of months and the tiredness was harsh. Luckily I had excellent (private) support throughout and was discharged from my psych at 6months pregnant (last Easter) (with the proviso I contact him the moment anything seemed not as it should be).

You are on a low dose so you might actually be better coming off than you realise. Pregnancy does make you wobbly emotionally speaking anyway, so if you do decide to give it a go, you have to work hard at not overpathologising what you're experiencing. I was lucky to have had a good psych & therapist to guide me through it, otherwise I would have panicked lots. It's stood me in good stead for my current pregnancy too.

What I forgot to say was that everyone wrote me immediately off to definitely get PND. I haven't! It is possible to kick anxiety & depression and the AD's if you have the right support & the right circumstances & enough time. Sadly few have those luxuries in which case, there is no shame.

One day at a time x