Pregnant and Sertraline 50mg?

[AnaCav]

Hi everyone,

I'm currently 24 weeks pregnant (I'm 35 y/o) and thank God feeling fine - psychologically - at the moment. Physically things have always gone great with pregnancy, but I have OCD since i was 18 years old, and the month of February was not easy for me.

A bit of background: at 25 y/o, I started taking Clomipramine 10mg, a very small those, and that alone put my OCD under control for 10 years. OCD was related to obsessive thoughts but it never really gave me anxiety, I have never been an anxious person, I would just be tired of thinking/wondering about these thoughts and checking, but it wasn't something that would cause me extreme stress. When started to try to get pregnant, and because Clomipramine is not safe during pregnancy, I decided to go off of it. After a couple of months, I felt some signs of ocd coming back, but very mild and I was doing fine, it wasn't interfering with my mood or day-to-day life, more of a "oh, this is an ocd thought, gonna ignore it".

I got pregnant and the first 4 months of pregnancy were great, no anxiety, no bad ocd. Just feeling completely normal. Then as I entered the 18th week, I started doing the renovation in my house which made me leave my house for a hotel, where I would stay 5 weeks. It was here that I really suffered: on Feb 2nd I had a bad case of ocd, but which was not accompanied by anxiety. This bad patch of ocd - related to the pregnancy - lasted until the Feb 13th, and the heavy car traffic around the hotel made it very difficult to have comfortable nights, so I was sleeping really badly, which didn't help. Then, on Feb 13th, my first experience with intense anxiety started, not a panic attack, but intense anxiety and really bad sleep. I immediately thought: this is bad. I immediately asked for help: I left the hotel and talked to my parents (they live next to my home), my husband was supporting me in every second, immediately found a cognitive behavioral therapist, and 2 days later, was in therapy for ocd and anxiety. I also had an appointment with my obgyn, who told me there is medication that is relatively safe for pregnancy, so I also scheduled a perinatal psychiatric appointment, for March 16th. I moved hotels, which helped but I was still missing my home and not getting great sleep. I was able to return home on March 1, and that coincided with the OCD receding and getting much better. For a week, I had no OCD, but I had these really weird physical symptoms of generalized anxiety, a permanent feeling of anxiety not associated with any particular bad thought or fear, at least consciously. After 5 days, that permanent anxiety disappeared, I'm back home, and have been feeling normal and relaxed since then.

Still, I kept my appointment with the psychiatrist and she prescribed me Sertraline 50mg, saying that third trimester will likely bring my ocd back, that she has all her ocd patients medicated during pregnancy and that anxiety is worse for the neurologic development of the baby than the low risks associated with taking Sertraline. At the same time, I read all this stuff about Sertraline in pregnancy and while it seems to be the safest option during pregnancy to treat ocd and anxiety, studies are confusing and the possible slight increase (even though still low in absolute terms) of autism, preterm birth, or lung syndrome after birth, baby feeling withdrawal,etc., scared me. At the same time, researchers seem to not know whether for autism or preterm birth, it's the underlying condition or the medication that slightly increases the risk. And 50mg is apparently a low dose.

I basically have no idea what to do. I'm back home and feeling well, like I felt during the first 4 months of pregnancy. But the psychiatrist is strongly in favor of me taking it. The doctors says it's relatively safe. It seems like not doing medication and having anxiety may be worse for the baby that taking it. But at the same time, because I'm feeling normal and safe back at home, i'm struggling with the decision.

I know ultimately it's my decision, only I know how I feel inside in terms of anxiety, but would you guys have opinions/past experiences that might help?

Thanks and so sorry for the long text!

I took sertraline from when I was about 12 weeks pregnant with my daughter. I then breastfed her for about a year and was still talking it then. It didn’t have any noticeable effects on her but made a lot of difference to me. She’s 16 now.

I was taking it for depression; I haven’t suffered from OCD so don’t have any experience of that but just wanted to let you know my experience.

Thank you so much for your reply and experience! This cost-benefit analysis is really tricky, as I'm now feeling back like I was feeling the first 4 months. But a month ago, I really suffered psychologically. Don't want to happen again. But at the same time, I did everything to help improve my condition outside of medication - cb therapy, went back home, sleeping great, doing mindfulness - and it seems like those measures have worked. But delaying medication might be risky, if I have a relapse. Should I wait and see? Should I act now? Very tricky.

Have you looked at the Bumps website (best use of medicine in pregnancy)? It's ultimately up to you but I'm on 100mg sertraline and 11 weeks pregnant. Doctor and midwife advised to stay on it (I wanted to reduce to atleast 50mg) midwife said its the best med as they know baby doesn't withdraw and you can still bf on it. I think the autism link is really low and it's also genetic so mother/father may be autistic but because of the research /meds it gets put down as meds.

Will definitely check it out! Thank you so much. Did you start the medication before or after getting pregnant?

I'm taking sertraline for ocd, was prescribed it at about 25 weeks but took me a few weeks to take it. My consultant was really pro me taking it and my midwife also said they've never seen babies with problems such as breathing etc in the hospital. With DC1 I was awful after her birth so I really don't want to go back to how I was back then.

Thanks for sharing, as I'm also an ocd case. I did a lot of cognitive behavioral therapy since my ocd kicked in again on Feb 2nd and so far that seemed to have helped a lot. If I had been prescribed this a few weeks ago, I would not hesitate. My hesitation comes from the fact that my anxiety levels have been really low, ocd has receded, and I'm enjoying this period of peace and tranquility. I just don't feel like disrupting that by introducing the medication that will likely disrupt that for the couple/few weeks it takes to adapt, although I know after those weeks I would go back to feeling fine again as I'm doing now. But it is really nice to know that Sertraline seems to be really safe and that other women have good experiences with it during pregnancy. I bought it already so it's right here for me to be ready to take it at any moment (they were prescribed yesterday).

Hi OP, I've been on Sertraline for ten years plus for generalised anxiety disorder and OCD, I took it during my last pregnancy, 100mg daily until I knew I was pregnant and then with the GP's agreement, reduced it to 50mg daily. At 20ish weeks, I was really struggling with anxiety so increased back up to 100mg daily until baby was born. He had some slight withdrawal symptoms following birth (medics described it as 'being a bit jittery') but it passed within a day or two.

I'm now pregnant five years later with baby no.2 and have stayed on 100mg daily throughout, both midwife and GP have advised staying on my current dose which I think is sensible.