Sertraline and pregnancy

[Apanicaday]

Hi. I was wondering if anyone could give me any calming words of advice/reassurance, or point me to where I can get some. I have suffered with general anxiety disorder and OCD for years and years - it comes and goes, and has been at its worst when I am stressed, and when I am pregnant. I struggled through my first two pregnancies, but they were pretty unpleasant experiences mentally, and after the last one I ended up in a big mess, which needed some serious counselling and citalopram, and took me a good year to get over. I think it happened largely because I had struggled so much throughout the pregnancy, that postnatally I just couldn't cope any more.

I am now pregnant with my third, very much wanted and planned for baby. And I am a wreck. I'm 12 weeks, and have spent the last 8 absolutely 100% convinced that it's all going wrong. Totally and utterly sure that every time I go to the loo I'm going to find blood. I have to psyche myself up to actually go to the loo, and then wipe myself over and over to make sure there isn't blood there (and I have convinced myself several times that there is, when there isn't). I had hoped that getting to 12 weeks would help, but it hasn't. I recognise that my thoughts and actions aren't rational, but I can't stop the negative voice in my head and it's "but what if's". Every twinge, or change in symptom or difference from the day before is a sign that it's all gone wrong and I'm losing the baby.

I've been seeing my GP on and off, and have a referal to the mental health nurse, but I really know that counselling on its own isn't going to be enough to make me feel well - in the past it has worked beautifully but only when I've taken the meds as well. The GP has given me a prescription for sertraline, and been through the whole risk benefit thing with me. The problem is that a lot of my anxiety centres around harm coming to the baby, and I an terrified that by taking the tablets, I am putting my baby at risk. I worry that I'm being selfish - how can I judge that it's worth the risk to the baby just because of my mental health being bad? And I'm so very very frustrated with myself that I can't just get over it and cope.

What frustrates me the most is that before I got pregnant, I swore to myself that if I felt my mental health slipping this time, I'd take the medication. But now, with the anxiety in full swing, I can't stop the negative thoughts from persuading me that it's the wrong thing to do.

I just don't know what to do with myself at the moment :(.

Hi, I could of written your post excately I'm 22 weeks and have had anxiety and depression for 8 years on and off and have been on all sorts of anti depressants. When I feel pregnant this time with dc2 I thought right nows the time to come off them so for about 15 weeks I've been off them and been feeling so good. Until a few weeks ago when I relapsed again and irrational thoughts started and have spiralled out of control. My obession like urs was the health with the baby at first and so I held of from the tablets until I could feel him moving so I knew all was ok but now I can feel him moving I still don't feel n e less anxious! It's got so bad I have to go back on setraline!! For my own health aswell as for the sake of the baby's because I was starting not to function right and was so stressed it must of harmed him!! It's up to u wat u do I can totally understand ur fears but ur health while ur pregnant is so important and the risks with these tablets are so low but they have to cover them selfs. I know a few ppl who have been on them and all ok I also have been to see the consultant at the hospital who thinks I should of been on them. Sending you a hug cos I completely know we're u r right now and it's not a nice place. I'm waiting for the tabs to kick in cos I can't cope n e more with how I am at the mo. xxx

There are small risks with Sertraline but the biggest (and its still negligible) is caused during the first 12 wks. You are passed this stage now. The slight chance of baby withdrawal after birth doesn't have a lasting affect and is over in 24-48hrs if it even happens which again is relatively rare.

Stress and anxiety can affect your baby. It can affect development, growth etc.

I am pregnant and on sertraline and there seems to be no affect at the moment. I think knowing that a mother emotional well being does affect a baby and that sertraline may but probably will not have any affects on the baby helped me make my decision.

Also on sertraline. I think, weighing up the pros & cons that the risks are v small. Your own emotional wellbeing has to be a priority too.

I'm 8 weeks and taking 25mg of sertraline daily (was on 50mg before). The risks are very small and unfortunately it's not a case of no medication=no risk as untreated depression/anxiety carries its own risks. Not least increased risk of PND. Plus you're past the most 'dangerous' stage for taking medication.

It was a hard decision, the half tablet a day was a compromise between no meds and a 'proper' dose. But I was pregnant over the summer, came off medication (then venlafaxine), mc anyway and DH begged me not to come off them this time, as I was a nightmare last time. So after the mc I went on one considered 'safe' during pregnancy. I had every intention of staying on it if I became pregnant again, but it was still a hard decision when I got bfp, as all that logic went out of my head!! So far I am coping a lot better this pregnancy (apart from damn sickness which I didn't have last time).

Almost all research studies out there find no increased risk in taking SSRIs in pregnancy, but they can't say statistically for sure as numbers in these studies are too small considering the rarity of the conditions they look at in the general population. Also the doses of meds are all different as it's not ethical to study drug effects in pregnant women (they look at it retrospectively, so women who have already chosen to take meds at various doses/various stages of pregnancy already). OTOH there are well documented risks with untreated depression/anxiety. Still it is hard to look at objectively even if you have a research background!

I took sertraline while breastfeeding DS1, while pregnant and breastfeeding DS2, the beginning of pregnancy and breastfeeding DS3. With DS2 I came off them at 36 weeks because I wanted a homebirth and I had to have been off sertraline for at least 2 weeks beforehand.

The GP told me there was a slight risk of heart defects before 12 weeks and risk of withdrawal if taken within 2 weeks of birth. However the risks are less if you're on a lower dose.

Thank you all - your posts make a lot of sense and do reassure me. It's so hard to make this sort of decision when in the middle of an anxiety phase (or any rational decision). Having spent today on and off in tears because my bits are sore (probably just an infection, but in my mind it's the end because it happened before my miscarriage) I think the only sensible thing to do is take them - if only for the sake of ds1 and ds2 who deserve better than a miserable anxious unhappy mum. I'll go and pick up my prescription on Monday and start then I think (not looking forward to the early side effects, but I know how much difference ssri's have made to me in the past, so I'm hoping it won't be so grim this time).