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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Taking citalopram before and when pregnant - dangers?!

9 replies

Nztb12 · 28/10/2018 09:06

Hi everyone, I’m new to this! Saw a few threads about this from a few years ago. But wondered if anyone had any recent knowledge? as I think the threads were getting on for 10years old! I’ve been taking citalopram for about 18 months. The highest I went to was 30mg, I’m now on 10mg. I must admit I haven’t been to the doc for ages as my GP (who was amazing!) left the practice. So have just gradually cut down myself, which is what we had always discussed doing eventually. I actually stopped taking all together at one point but started getting very anxious and worrying a lot so started taking again.

But now I’m pregnant and I’ve been reading all this research about birth defects it can cause etc I feel I should just stop taking straight away?! Does anyone have any recent experience of being on it when pregnant? Any advice? I feel like I’m getting more anxious about harming the baby being on it! But I don’t know what I’d be like if I came off. I’m also very early in, have only just found out I’m pregnant and probably about 4 weeks. Please help!!

OP posts:
TheDayMyButtWentPsycho · 28/10/2018 09:17

Hi! I was you, and I googled a lot as well.

I was on 20mg and cut down slowly to nothing by 5 months pregnant (I'm 7 months now).

10mg is a very low dose which is a good thing and well done for cutting down from 30.
There are some very very small links to fetal heart defects, but what is more important because it's not a small link, is maternal mental health.
If 10mg is what keeps you balanced and healthy then stick with it. The pros very much outweigh the cons.
However, if you want to cut down then do so really slowly. Although in my book I figured that if it was linked to heart defects then by the time I'd come off it, his heart was already built anyway.

The reason I came off it was because I took it for PMDD. And since it's going to be a while until I have periods there's absolutely no point me being on it.

Speak to your midwife and she will advise you as well.

TakingtheLeap · 28/10/2018 10:19

Hello! Thanks for posting this - I'm in a similar boat and would appreciate seeing responses to this question too.

For myself, I am 6 and a half weeks pregnant and had been on citalopram for a long time prior to getting pregnant. I tried to come off whilst TTC but TTC took a while which made them more needed, if you see what I mean!

Now I'm pregnant and with the advice of my doctor I'm starting to wean off - currently taking 3 doses of 10mg over a week (after dropping to 10mg and then to 10mg every other day). I'm finding it a bit hard in terms of side effects as on my off days I'm getting a lot of dizziness on top of pregnancy symptoms, which makes functioning quite hard. That said I haven't had any emotional impact from coming off yet.

All that said, if I do find my depression returning I WILL go back on them - as Psycho says there are suspected side effects on baby of taking citalopram but proven side effects from depression. I am also going to flag my history of mental health up from my very first midwife appointments onward and start conversations early about PND and taking SSRIs whilst breastfeeding.

Some regions have dedicated antenatal mental health teams - sadly mine doesn't - but it may be worth looking into whether yours does. Also don't necessarily rely on what a GP says; I know mine just relies on a book which has very very vague information about maternity and antidepressants (e.g. suggesting that breastfeeding should be discontinued! - which a little internet research suggests is not necessary). So, insofar as your mental health enables you to, ask lots of questions and be proactive about advocating for a course of treatment which is best for both you and baby.

TakingtheLeap · 28/10/2018 10:22

Also, do not stop cold turkey! Even from 10mg.

Also bear in mind that what limited research has been done will have dealt with a range of doses - 10mg is a relatively low dose. As with all pregnancy advice (alcohol etc) the standard line will be that no risk is small enough - but a smaller dose is "better".

FlippertyJibbet88 · 28/10/2018 10:40

Hi there,

I am currently pregnant with my second (due any day now!). I have a history of anxiety and depression and was on citalopram throughout my first pregnancy (10mg). In my first pregnancy I was advised to come off the drug, but was then diagnosed with pre natal depression and my GP decided it was best I stayed on.

My baby was born with physical limb differences which were picked up at my 20-week scan. This obviously caused a huge amount of extra stress throughout the remainder of the pregnancy and I stayed on the citalopram. I was seen by a whole raft of consultants who all unanimously agreed that it had nothing to do with the citalopram and was just one of 'those things'. Having met many more parents in the same situation -none of whom were on citalopram - I agree with the veredict.

However, despite knowing this I still felt I couldn't continue to be on the drug during my second pregnancy. As you have come on here asking it shows the lack of clarification there is out there on this particular drug - there just isn't enough research into it to prove that it's safe. As soon as I found out I was pregnant for a second time I stopped my 40mg dose cold turkey. As a previous poster has said DO NOT ever stop cold turkey. It led to a total mental breakdown for me that lasted the whole of the first trimester! My GP and mental health team are all quite keen for me to go back on citalopram (which should be reassuring for you!) but are luckily respecting my decision to stay off.

I am better now from the initial cold turkey shock, but there's no denying that I could really - really - do with being back on my citalopram! However, I've put other strategies in place. I am under the care of my local Perinatal Mental Health Team, who've offer anxiety workshops etc, I'm also doing an online hypno-birthing course.

It is such a tough decision and it's made all the more difficult when anxiety and depression are involved. As I said, I chose to come off for my own peace of mind - being on the anti anxiety drug was, ironically, going to make me way more anxious!

If you're still unsure you could look into trying something like Sertraline, which has had more research done into its usage during pregnancy and is generally considered the safest anti depressant to take during pregnancy. I didn't go down this route as I knew that citalopram worked for me and I didn't want to mess around with something else due to my experiences in my first pregnancy. However, I have two friends who did switch to Sertraline during pregnancy and after and found it really helpful.

As much as we with anxiety might want definitive answers, unfortunately where something like citalopram is concerned you just won't get them as there isn't enough information available. You may find GPs suggesting to take it for your own mental health (like mine do) but you won't find a medical professional who will guarantee to you that it is definitely safe. I found that lack of certainty really difficult to reconcile with which is why I chose to come off it. But the nature of everyone's anxiety is different and for me that was a trigger.

Best of luck with whichever decision you make, I really don't think there is a right or a wrong answer, there is only the best choice to make for you. For everyone who tells you to go drug free there will be another who tells you 'happy mum = happy baby'. So it really has to be a decision that you are comfortable with given the information available.

If you haven't already, speak to your midwife about your perinatal mental health team and other supports available to you as well. Good luck!

Nztb12 · 28/10/2018 13:06

Thank you all so much. Everything you’ve said has been very reassuring so far. I think maybe trying to gradually come off may be an idea, going to try see a GP ASAP to discuss it. I think I have a similar mindset to you @FlippertyJibbet88, I will feel more anxious being on them than off them in this scenario! It sounds like you’ve been through an ordeal, but have come out the other side and it will all be worth it when the little one is here - which will be v soon by the sounds of it :)

OP posts:
TheDayMyButtWentPsycho · 28/10/2018 17:58

FlippertyJibbet88 that's interesting because my baby has a problem with his heart and the consultants say to me that it's unlikely to be the SSRI's yet it says in my BNF that there is a link.

I don't see how consultants can poo-poo it so readily.
I was going to mention my baby's heart problem because I still assumed that perhaps it wasn't to do with taking that drug. But since you have mentioned that, it does make me think....

Darkstar4855 · 28/10/2018 18:13

I have been on 10mg citalopram long term. I weaned myself off it when ttc, managed to stay off until I was 8 weeks pregnant and then my mood got so low I could barely drag myself out of bed and was crying at every little thing, couldn’t bear being in the house alone etc. I went from desperately wanting a baby and being terrified about miscarriage (I’d been having spotting) to thinking “well at least if I miscarry I can go back to feeling normal again” which was totally out of character for me.

I agreed with my midwife that the best thing would be to go back on it and she referred me for an appointment with an obstetric consultant who specialised in mental health in pregnancy. His advice was to stay on it for the whole of pregnancy as the risks to the baby were small and it was better for me to be stable than try to come off it again.

I was back to my normal happy self within a few days of restarting it. I am now 35 weeks and have had an uncomplicated pregnancy with no sign of any abnormalities on my scan. I was worried about PND so I feel better for being on the citalopram. I feel like I did my best to come off it but ultimately for me the need to protect my mental health outweighed the very small risk to the baby. I certainly could not have done another seven months of feeling like I did at eight weeks.

FlippertyJibbet88 · 28/10/2018 18:31

@TheDayMyButtWentPsycho That's really interesting. I wish someone had the time and the inclination to do some proper studies into it so that mothers could use it with peace of mind.

At my follow up appointments I insisted they filed what they call a 'yellow card', which is a log of an abnormality of any kind while on a drug. I remember my consultant being really reluctant to file it, presumably because she felt it was unrelated and didn't want to frighten anyone. I insisted, but I always wonder if she ever filed the card or not...

unicornchaser · 29/10/2018 01:17

Hi OP, I was on citalopram long term before pregnancy for anxiety. Managed to get myself off it before actually conceiving but within 12 weeks I was struggling without it.

Doctor wasn't comfortable putting me back on it but did put me on sertraline as this has had more research and testing done on the possible effects to baby than citalopram. Think sertraline is more commonly the drug preference for pregnant women.

It's only a low dose so I still struggle but it's enough to take the edge off most of the time.

I would say speak to your doctor before you do anything though.

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