Coming off antidepressants when pregnant

[HollyLouise93]

Hi everyone :)
Found on Christmas Day that my partner and I were expecting another addition to our little family (planned and very excited!)
Since then I’ve spoken to the gp and she has strongly advised me coming off my antidepressant, cold turkey actually, I was on citalopram 10mg. I have found I am now really really struggling. My anxiety and intrusive thoughts have come back with a force and I’m finding it really hard to cope, so much so my suicidal thoughts are in full swing. Went back to docs, and even after telling her all this she still told me horror stories and has made me to scared to go back on it. Feeling very stuck as I’m not eating, not functioning properly, don’t wanna do things like bath or clean the house all I wanna do is sleep the day away as an escape to how I’m feeling. Has anyone else taken citalopram through pregnancy and baby has been healthy? Been told all about birth defects, heart defects and baby suffering with withdrawal symptoms. Any advice would be greatly appreciated x

Some anti-depressants are considered 'safer' in pregnancy than others, mostly because they have a longer history. It's considered unethical to do drug trials on pregnant women.

I was on fluoxetine during early pregnancy. My depression was caused by the stress of infertility, so it made sense to (slowly) come off them, even when I was on the lowest dose.

Her being adamant you shouldn't be on anything doesn't sound right with the severity of your symptoms. Is there a different gp you could see at the practice? Could you talk to your midwife about an (urgent) referral to the mental health team?

Very sorry you're going through such an awful time!! It sounds strange from your gp...

I was on 20mg of citalopram until 8 weeks. My GP advised me to taper off over 2 weeks. Not because of the risk to baby which he said was very low but because the situation I was taking them for was starting to ease.

After reading of other people's experiences of coming off citalopram online I decided that a 6 week taper would be less likely to give me withdrawal symptoms. I read these could be quite unpleasant and similar to the depression I had. I had no problems tapering off over 6 weeks and my 4 week old is healthy and happy.

I would go back to your GP or maybe a different one and let them know how you're feeling. It's better to be on a low dose of antidepressants than go cold turkey if it's going to make you feel unwell. Ask about tapering down to reduce the chances of withdrawal symptoms. Also consider if talking therapies like CBT might help. I have done a course of that in the past and it was great for reducing anxiety and unhelpful thoughts. That said, I'm not a doctor and you should listen to your GP over some random on the internet. Just sharing my experience in case it is helpful.

Take every opportunity to relax that you can and focus on your self care and positive thoughts about the baby. Good luck and best wishes with the rest of your pregnancy.

Thank you both for your replies! Rang gp not long after posting this and asking for a call back off a different doctor so just waiting on that at the moment. Last gp I saw which was on Wednesday was very adamant, wouldn’t even go through potentially ‘safer’ antidepressants too take, just signed me off work for 2 weeks and put me on a waiting list for the counsellor which she informed me could be atleast 6 weeks. Found her very unhelpful so hoping the phone call I’m waiting for will do me some good. I have a 5 year old son I’m trying to look after also and I feel guilty for not being as I was before coming off meds, finding it all very difficult and sick of being tearful. Thank you both for the advice x

Don’t suddenly stop taking citalopram! The instructions actually say this in bold! The withdrawal effects can be strong. I was on citalopram and ttc, I went to my gp to discuss whether I would be able to continue in pg. she sought advice from a psychiatrist who said it would be a medication they would ever start someone on when pg, but if I was already on it they would recommend me to either switch to another drug more compatible with pg or to reduce the dose of citalopram gradually during pg to ensure I was off it before birth. I started to slowly come off it about 6 months before I was pg and now I’m on 1/6 dose every 3 days so nearly at the point of nothing (I’ve done it very slowly because I had increased anxiety as I reduced each dose so waited for it to level out before further decreasing dose. She said I’d need to be off it before giving birth as if baby is born with me still taking it the baby will have withdrawal effects from it. There are a lot threads on mn if you search with people on citalopram during pg and weaning off in the last few months. Please don’t stop cold turkey, get advice from another gp about either switching to something else of coming off gradually. I’m glad your gp is getting you some counselling so is dealing with the issue but just being told to stop taking your medication and waiting at least 6 weeks for help isn’t great, especially with the emotional turbulence of being pg.

Would never start someone one, not would ever start

Thanks for the post reastie, already come off it cold turkey as it was suggested by my gp to stop immediately that day, as you can imagine this has frightened me about taking citalopram ever since. Waiting on a phone call this afternoon from a different gp and I am going to ask if there’s something else I can go on as this I’m 2 and a half weeks off my meds at the moment and it’s absolute hell. Can’t find happiness in anything, even the pregnancy anymore!

Poor you holly, I’m not surprised you’re struggling. I hope the next gp is more open to helping you. My mw was very aware of options suitable in pg so if no joy with gp maybe call mw, they would be able to refer you to a consultant to help.

I've been on sertraline since before I was pregnant and have no plans to come off it - my psych is happy for me to stay on it and it's pretty much safe during pregnancy. That might be an option? I'm definitely of the view though that the mental stress of trying to come off ADs is way not harmful than the meds themselves.

that is pretty dangerous advice from a GP and then to scare you with horror stories. that warrants a complaint to pals- no one should stop their dose cold turkey. Im horrified that any health professional would suggest it.

Sertraline is safe to take in pg, and may work for you, def talk to another doctor and demand an alternative as its not good for you to be feeling like this.

I was switched from paroxetine to citalopram for both my pregnancies as it is considered safe to take. I saw a consultant in Obstretric mental health and he recommended it. I was on a higher dose too. Absolutely no problems with either baby. My consultant said in his career he'd never seen any baby have problems caused by citalopram.

Obviously it's your decision but don't feel you need to stop taking them x

Thank you so much everyone for taking time out to comment, makes me feel so much better knowing there is always people I can talk too! Spoke to different gp on the phone and within 30 seconds of listening to me he told me the whole situation is no good and prescribed me fluoxetine for me to pick up immediately. I’ve never been on these ones before, so got my fingers and toes crossed they will help! If anyone can share their stories about fluoxetine I would greatly appreciate it :) thanks again everyone x

Been on fluoxitine forever. It saves my life. However when you first start taking it it can make you exhausted, anxious, and nauseous for a couple of weeks so be prepared for that

I’m glad you’re getting this sorted out. That first GP’s advice was absolutely shocking! I agree with PPs that you might want to talk to the practice manager or regulator about that advice... in anyone with less self-awareness than you have, that could be disastrous. I really hope your mood settles quickly with the new meds. Congrats on your pregnancy!

Absolutely appalling advice from your GP. Mine recommended I taper off when I first became pregnant but to do so slowly. My consultant is also perfectly happy to see me going back on Citalopram if I need it. Indeed, I've been asking about other antidepressants because I've read that Citalopram isn't the best for breastfeeding, and she said she was happy for me to consider other medicines but that usually they'd prefer to put me on one that I already knew worked for me.

It sounds like you're pretty early on in the pregnancy, but once you see your midwife ask if there are any referrals she can make for you related to mental health. My area have been absolutely fantastic in looking after me. I see a psychiatric nurse once a month and as I mentioned above also have checkups with a consultant. Prior mental health issues increases your risk of PND and for me it helps so much having healthcare professionals already keeping an eye on me.

Also, congratulations!

Also bear in mind that there is so little evidence, relatively speaking, about antidepressants and pregnancy - and what evidence there is isn't great at distinguishing between the effects of different drugs. My consultant pointed out that the impression that some drugs are 'worse' than others may be due to sample sizes - e.g. either one drug has been around ages so there have been time for the relatively few negative side effects to be highlighted (and another drug lacking evidence for those risks doesn't mean those risks don't exist) or conversely a very small sample being skewed by one or two bad outcomes, which might not represent population risk.

I'm not sure if she talks about antidepressants in great detail, but Emily Oster's Expecting Better has some interesting discussions about the problems of doing scientific studies on pregnant women, and how this can skew findings.

Incredibly dangerous advice from the first GP. I am on sertraline and ended up having to ask if it was okay to stay on it as neither the midwife or GP said a word about it! They both told me it was fine and that was that.

I hope things get easier for you soon.

Fluoxetine saved my life too. I was in the grips of it from infertility. I had a plan and a date. It came along just in time. I was tired for about a week and felt a bit out of myself (which I probably needed!). A very low dose really sorted me out.

I hope it helps you just as much!! Good luck!!

You need to see a different GP, yes there are risks when taking antidepressants in pregnancy and yes sometimes babies suffer some withdrawal symptoms. However the vast majority of pregnancies and babies are absolutely fine and right now the risk of your mental health declining is higher, particularly as you feel suicidal.

I think they told you to stop cold turkey as 10mg is the lowest dose ..although you could of took it every other day that’s what my GP suggested if I wanted to stop or try an cut a tablet in half again. I am on setraline 25mg an GP said it’s safe to stay on through preg...see how you get on with fluxotine I personally couldn’t manage the side effects and I have tried a few , but u may be different, if you want to change I’d recommend setraline it has helped me massively an had no side effects. Stay strong I have been there , it’s not nice xx