Citalopram in pregnancy

[LaMadrilena]

Hi again. I've been taking Citalopram since January, and am now 6 weeks pregnant. Everything I've read about it says it seems to be safe (although there aren't definitive studies), but that it can cause withdrawal symptoms in the newborn. My plan was to get through the first trimester, then start reducing the dosage, to come off it well before giving birth if all goes to plan.

Today I had a routine call with a locum doctor, and she insisted I had to come off Citalopram immediately. Didn't even ask me what I was taking it for or how I was. No guidance on how to reduce dosage (although I've done it once before, so I've more or less got it figured).

A few weeks ago I spoke to my regular doctor who didn't mention any problems.

Does anyone have any experience of this? Should I be as worried as I am now?

Hi OP, I've been on Fluoxetine for years and when I was around 12 weeks, I was told to wean myself off of the medication due to withdrawal for the baby.

Fast forward several weeks later and I became incredibly depressed, anxious and paranoid.

My midwife had already booked me in with an antenatal mental health consultant around 23 weeks who said I should not have been taken off my medication and that the danger to my baby was minimal.

If you remain on your medication, they will probably say that you will need to be kept in at least 24 hours after birth to monitor withdrawal in your baby.

I'm totally fine with that, as I'm Group B Strep positive and will need to be in for at least 24 hours anyway.

I'd say go with your gut. I think if I wasn't put back on my meds, I would be in an incredibly dark place. Being pregnant is already so stressful, so if medication helps don't feel guilty for staying on it.

I took it all the way thought my pregnancy as the alternative would have been damaging and my son is as perfect as they come.

Ps, dosage 30mg

Sorry, this has really annoyed me. Your locum is irresponsible saying this. I was on warfarin until I was 9 weeks gone as didn't know I was pregnant until then and even that wasn't a huge issue.

Thanks everyone for your comments. I've just managed to speak to my midwife who says ideally I should come off gradually if possible. If not, to maintain the lowest dose possible, which seems more reasonable advice. I'm a bit reassured now.

@Ingridla I know, she was really rude and dismissive. I just didn't feel I could argue - she's the doctor after all. She also told me off for not asking for an appointment earlier re the cystitis I also asked about. I was just trying to taking up an appointment unnecessarily - this is in Madrid where the health service is on the verge of collapse.

my sister was on 40mg throughout both her pregnancies and no one ever even suggested she come off it or go down to a lower dose. the only thing said was that she may have needed to stay in hospital a day or two longer to keep an eye on the baby (but it wasn’t specified why), but in the end she came home the same day with both - both perfectly healthy babies.

Midwife here. I would recommend staying on your usual dose, not reducing or coming off. This is in line with current guidance from perinatal mental health specialists. This tends to be safer for mum and baby as unstable mental health is likely to be more dangerous than the very minimal risks associated with SSRIs.

I was on 10mg when I was pregnant with my son in 2018. My MW and GP recommended I stayed on it as there was a bigger risk me coming off it. My son was born at 40 weeks with no problems. They did keep me in a bit longer to make sure he had no withdrawal symptoms.

It's safe, I'm a therapist and work with plenty of pregnant women on medication xx