Antidepressants in pregnancy. Rock and a hard place??

[Blundermum]

I am a 40 year old mum to DD (4) and pregnant again, only about seven weeks so far.
I have a long history with depression and had pnd after DD was born. I chose to stop taking antidepressants during my first pregnancy and while I just about held it together, things went downhill very quickly after she was born. I just remember it as a black time with thoughts of suicide and complete worthlessness. Horrible.
Antidepressants put me right though and have been 'normal' for years.
I always thought if I got pregnant again I would just keep on taking them however I have spent HOURS on the internet and it seems there are risks in taking them but risks in depression during pregnancy too!!
I feel terrified as depression ruined for me, what should have been a joyful time and almost wrecked my marriage to boot.
I stopped the antidepressants four weeks ago and allready feel I'm spiralling downwards.
I think I was selfish in thinking I could have another baby as it seems I could harm it whatever decision I make.
Please help, has anyone else been in this situation, or maybe had advice from a specialist who knows a bit more about the risks?

Yes, I was told to come off my ad's, but decided to continue but on a low dose. Depression in pregnancy is common. I would go back to your dr ASAP. I have been told I will be under consultant led care due to ad's.

I've had 2 babies on Prozac 20mg daily. One is 2.7 & the other is 12 days old. I've been on antidepressants for most of my adult life & cannot be off them, I get very depressed very quickly if I come off them. Both my boys are fine. Please don't let this put you off having another child if you really want one.

Hello - I'm a GP and yours is not an uncommon situation. It is about finding a balance though - no medication is ideal in pregnancy but equally you have to weigh up any potential risks of taking a drug with the potential harm in not having treatment for your condition. For example, there are medical conditions where it is simply not an option not to take a drug eg. epilepsy. Depression is harder, because while the effects of it can also be severe, they are more difficult to quantify. Equally there is the guilt factor of mums thinking "I should be able to cope". Firstly, try to remember that depression is a well recognised and common medical condition, it has nothing whatsoever to do with personal weakness or ability to "cope". You need to try to take a step back and be objective and honest with yourself about how you are feeling. Remember that if you are struggling it could have an impact on your relationship, how you react to and communicate with your daughter, and also on your bonding with baby. Your GP will be able to chat to you about the different types of antidepressants as some are more widely used in pregnancy than others. If you really hate the idea of taking something while pregnant, one option would be to try to wait until you have finished the first trimester. Certainly with SSRIs, the most common family of antidepressants, the potential risks are greatest in the first trimester. I have seen a lot of women who have taken antidepressants throughout their pregnancy however, with no problems. I would definitely go and talk to your GP and see what they advise, and also make sure your midwife understands what you went through last time and knows to make sure you get plenty of support from the health visitor after the birth. All the best xx

I didn't for first three month and ended up feeling lousy and very lonely... back on them now after much sole searching but best for me baby and my three children... i take 50 mg of sertrline a day xx

Ps i too had an awful time with first pregnancy ended up nearly killing my self... don't rem my twins first six months that was eleven yrs ago

i took sertraline with my youngest now a strapping eight yr old lad ...

I am 22 weeks pregnant and have been taking Venlafaxine 300mg all the way through and will continue to do so. I have a very long history with severe depression and have tried many different anti-depressants, none of which worked for me until this one i'm on now. I've had long conversations with my GP and psychiatrist and they all agreed that the benefits outweigh the risks. It is much better for my child for me to be on them and healthy than off them and totally erratic which would cause much more harm. I think that if you need them to be able to be stable and be the best mum you can be then you shouldn't feel guilty for needing them. Good luck and I hope you have plenty of support but please don't feel you need to come off them.

I'd been on Citalopram for 3 years [gruesome divorce/custody battle with a Narcissist] before falling pregant earlier this year (now 26 weeks). I came off Citalopram (on my GPs advice) pretty quickly once I realised I was pregnant

Coming off the Citalopram was very hard work (extreme moodiness, insomnia, irritabtility etc) but I persevered for a few months. However, ongoing stresses and strains (moving house, continued trouble from my ex re custody and finances, some family issues, very intense working hours) meant that my wheels fell off around 21 weeks pregnant.

My GP referred me to a psychiatrist who is also a qualified obstetrician and he put me on Sertraline 50mg. Like others have said, his advice was that it is all a balancing act in terms of working out what is the best approach to take. I felt like a massive failure for having to resort to ADs again but, I have to say, within two weeks back on them I felt again able to cope and to be a good mother to my existing DC and to take proper care of my unborn DC.

The psychiatrist I saw said that after 20 weeks the risk to the unborn child is pretty minimal (he talked me through it in much more detail so I could assess it). He also said that severe stress is harmful to the unborn child as well and can result in low birth weight and other issues. He advised Sertraline as I want to breastfeed again and it is the least likely to pass into my milk in meaningful amounts.

I have beaten myself up a lot about this but, at the end of the day, I've learned my limitations in terms of mental health and I also trust that I've had some really good advice from medical experts who've been really supportive of both my struggles with anxiety and depression and my desire to do the best thing by all of my children.

Good luck and, whatever your choice is, don't feel guilty about it. You will do your best.

Thanks all so much for your advice and for telling me your experiences.
I'm seeing a GP tomorrow and will talk it through with him.
So stupid of me to think, with my history, that another pregnancy would be easy. I think part of me will never stop feeling guilty about the pnd and stupidly thought I could do it 'properly', if you like, this time. I'm very sad to be feeling like this again and determined that it wont escalate like it did before.
I will post what GP says, bye for now xx

hey i'm 40, PG with DC2 (nearly 13 weeks) and came off fluoxetine as soon as i found out.

it felt like a slow tumble down a long flight of stairs with some really hard falls that really hurt, but between times it was sort of ok.

i think it's finally out of my system and although i don't like being at the bottom of the stairs, at least i'm not falling down them any more.

the first trimester is the most horrible constellation of worry and physical symptoms and quitting ADs makes it an even worse mix. but eventually PG gets easier and the quitting of the ADs gets easier.

i'm finding that having been on ADs is leaving a positive legacy - i know that if i don't get wildly overemotional and freak out nothing bad happens, cause i spent two years being unprecedentedly stoical whilst on them. I'd never experienced that before, and as such i'm slightly more emotionally controlled than i was. only slightly and only when the pressure is not too bad, but i have an insight into it at least.

i will go on them as soon as baby comes though otherwise it's gonna be a car crash.

please keep talking on here everyone - i would love to have good conversations about this as i'm going through it right now.

xxx

I know, its an interesting topic, not least because little or nothing is really known about the risks so there is no-one that can really advise you. Makes it a decision that you make yourself which is very hard to do.
People that have not had the horrible debilitating black shadow that is depression (lucky them!) would'nt understand why there was a choice to be made at all when there are maybe, slight risks involved but there are also risks to the baby if you suffer during pregnancy.
Like I said, rock and a hard place!!!
Would be really interesting to hear from a few more mums who took them and see if they noticed any adverse effects.
Please keep posting!

This might be worth hearing - I spoke to a maternity mental health nurse at some length and she said she and the consultant psychiatrist she works with have never seen the fabled side effects - jitteriness let alone PPH. She said sertraline is the one they prescribe to pregnant mums and she assured me it's completely fine.

that's the one i'll take if things get too much, and def the minute the baby's born.

Thats really interesting to know! I bet there are lots of women out there with little gems like this. Thank you!