Sertraline

[Cat2lady]

It's a bit long so bear with me....

Right so I suffer with anxiety and I'm generally a big stress head! A few years ago I was prescribed sertraline which helped and after a while, with my GP's knowledge, I stopped taking it. Within less than a year I went back on it again, it does help me.
So on finding out I was pregnant I did a quick google search and saw that it was apparently ok to continue with it.
When I saw my GP she said she would refer me to the mental health midwife team, she acted like it was more of a formality so I wasn't bothered.
Today a midwife from the mental health team contacted me and said whilst there was no evidence that it was unsafe there was no evidence to say it was safe and they do come across a lot of women who take it. She said that it increases the risk of persistent pulmonary hypertension (pph) for newborns. I've found information on this from GOSH and pph can cause serious problems because it can starve the brain of oxygen and possibly cause learning disabilities or even death. She said she didn't want to worry me but wanted to ensure that I had informed consent.

Now I feel like crap, like I'm putting my unborn baby at risk so I'm considering cutting the dose with a view to potentially wean myself off again (obviously would speak to GP too).

So I guess the point of this post is to ask if anyone else has taken sertraline when pregnant.

They wouldn’t let you stay on it if it was unsafe op and it’s better for both you and baby if you are less stressed. Discuss it with your Dr instead of googling. That will just drive you nuts!!
Have you discussed other options such as CBT? X

I'm got my booking in appointment on Wednesday morning so I'll speak to the midwife there then contact the GP.

I've had CBT in the past but I've got an overactive imagination that tends to run away with things, haha.

I'm on it 23 weeks pregnant and been to mental health team I'm in a mess and they won't listen to me

Relaxing2 sorry to hear that x

I think that’s a good idea op. EVERYONE gets anxious during pregnancy but when you’ve suffered with it it can spiral without speaking to someone.
Relaxing2, sorry you’re suffering. I’d book an appointment with your GP, write down a list of concerns/questions beforehand so you don’t forget anything and take someone you trust along for moral support. Make sure you get your point across and talk it through with themxx

Sweetheart I'm always with my gp he won't give me nothing else been on it 9 weeks and seen no change my anxiety is really bad making me ill always crying I keep phoning for help and all they say is clean up listen to music keep your mind busy

Wow. They suck. Is there anything your local wellbeing services can do to help? X

No nothing Hun they just don't want to listen just keep telling me do hypnosis I just want to relax

That’s crap sorry. Meds didn’t work for me either. Therapy helped and time and taking a break so I could rest was probably the biggest thing. I hope you can get some relief x

How long did therapy take to work

I had two lots of CBT. The first was a seminar style in a room full of strangers which I wouldn’t recommend. The second was one on one where I would talk about what was worrying me and the therapist talked it through with me and taught me ways to cope. That was about 6 weekly sessions I think + a workbook to do at home x

Is this well your pregnant

I was ttc at that point.

Did you have negative thinking and panic attacks in pregnancy

Absolutely! But I personally I think the therapy has helped because I can talk myself down and rationalise thinks whereas, at the height of my anxiety it would build until it became crippling x

Anxiety and depression don’t go away. You just learn ways of coping. Sometimes that’s easier said than done x

I totally agree with you there Hun just spoken to midwife she's going help me

That’s great. I hope it helps x

I'm on sertraline. I was on 150mg but reduced down to 100mg. Trying to reduce to 50mg but it's difficult as I get very anxious and can't manage. Everyone has told me that it's ok to take in pregnancy. The risks are very very low and they actually switch some women onto sertraline from other meds as sertraline is safer. X

I’m guessing you’ll want to ask some more questions OP. One thing it can be helpful to establish is “what’s the baseline risk for everyone, and what’s the risk if I keep taking this”. There’s a big difference between a drug which increases risk from (plucking figures from the air here) 1 in 10 to 1 in 5, as opposed to one which increases risk from 1 in 100,000 to 2 in 100,000 (even though they’d both be described as “doubling the risk”).

The other question then is what risks are increased by coming off the medication. Anxiety in pregnancy can be a problem in its own right, as you know.

You can also ask about alternatives, or what support would be available to you if you did come off sertraline - could the team offer you regular check-ups, for example, or a number to call if things get tough? Equally, if you stay on it, there might be ways to either reduce the risks of side effects or keep an eye out for them so they can be treated quickly if they do occur.

Once you’ve got a good idea of the risks on both sides and the ways to reduce them, you can set them against each other to make a decision that’s right for you. It’s unfortunate but true that there are lots of things researchers can’t put exact numbers on (antidepressants in general are hard to study, and no-one’s keen to run trials in pregnant women) but the more information you have, the more comfortable you can feel that the decision you’ve made is the best one possible. Which is all anyone can ask of you!

I'm 7 weeks and still taking my sertraline. Did loads of googling and it does seem the risks are low.

However, I was on 100 mg and for the last four nights I've broken them in half. Will try doing this for a few more nights and then maybe try and take 50mg every other night or something, just to try and wean myself off. I will discuss this with midwife this week.

In the mean time, though; I think it's better to have well managed desperation/anxiety than to spiral out of control again. The side effects from coming off can be horrendous, too, as you probably know.

Well, "desperation" was meant to be "depression"...

There will be risks with tablets like these because there will be no evidence due to it being unethical running tests on pregnant woman. I was on citalopram at the start of my pregnancy, the doctor was very matter of fact she said that problems that ‘could occur’ but not any real research done. The doctor said to me to decide if taking the tablets out weighs the possible problems which for me it didn’t, so I stopped them straight away (horrible!). But really let’s be honest when it comes to being pregnant there are so many risks. You just need to think if the effects of the medication the possible side effects of the tablets. In some cases if your going to be worse off without the tablets is the stress going to be great on the baby. Xxxx

Thanks all for your replies.

I was happy to continue with it being low risk, it was just that this particular midwife scared me. I've been thinking about it and I'm going to discuss reducing the dose.