This is definitely going to be a bit rambly but deep breath here goes:
I've always been prone to anxiety and low mood when the anxiety gets its claws in. I've been on 20mg of citalopram for 12 weeks now but don't really feel its having much effect. A few years ago I had a horrible episode and the only thing that helped was mirtazapine and psychodynamic therapy for a year. The mirtazapine had a wonderfully sedating effect which really helped me to sleep better and get control of my rampant destructive thoughts. I'd have stayed on the drug forever were it not for the insatiable appetite and the 3 stone I rapidly gained.
The GPs who I have spoken to are only willing to try fluoxetine, sertraline or citalopram as long term evidence seems to show no negative effect on the foetus (obviously RCTs would be unethical). I've vehemently stayed away from Dr Google but have been repeatedly told by midwives that maternal stress is known to have a negative effect on the foetus. So my quandary is do I ride it out (potentially risking the effects that stress may have on my baby girl) or push for a mirtazapine prescription knowing its likely to dramatically improve my frame of my mind but the effects of my foetus are unknown (again I haven't researched as I don't know where to start)?
As an aside I normally use high intensity exercise as a cure all for my frame of mind but my body just seems to say no, and so listening to it I've started antenatal yoga and walking but they don't seem to have the same rapid mood lifting effects.
I just wondered if anybody had any knowledge or experience in the area and could talk me through it. Unfortunately my trust doesn't seem to have a maternity mental health team but I have been referred for IAPT CBT as first line and a consultant obstetrician appointment to discuss my mood where I hope to be able to articulate both how I feel and ask for treatment which would be best for my baby. Any and all thoughts welcome. 