sertraline in pregnancy - sorry bit long

[Hearts]

I've posted this in "feeling depressed" too as not sure best place. Just wondered if anyone had any experience/knowledge of this.

I had dd in 2003 - had come off ads before trying for her but fell preg immediately...dragged myself to the 12 week stage then had to go on meds again - amitryptiline (advised that it was an older style drug and more tested in preg). Wasn't great on that so changed some time after dd born, and I have been well on sertraline for over 2 years.

Got to point where thought "I can cope with another child now!" and so weaned self off drugs to start trying. No joy and 3 months off drugs and I am going mad - feel dreadful and def need to back on the meds.

However, have just got a +ve preg test result....great news I know but I am depressed again and of course everything is bad news in my head at mo! I think I owe it to dd1 and to dh to go back on meds immediately but I couldn't live with myself if baby is harmed/I miscarry as a result of bl**dy inability to cope with life and my need for anti ds. Unfortunately the nature of the illness that has taken hold in me again means I don't see things straight and find it hard to concentrate etc etc so clear thinking decision making is not happening!

Gp wrote to consultant a while ago and his letter seems fairly positive about risks in preg being low, but was waiting for latest info. Saw gp Tues and nothing further in from consultant. She has written for urgent appmt for me so I am trying to hang on til seen him. Gp said if I really struggle then to just start the meds.

Thanks for reading and hope someone has some info/similar stories.

heasts, I've got to go out now, but will be back later. i've been taking sertraline since last June, but stopped when I thought I might be pregnant. i'm now 10 weeks and struggling a bit and wanting to go back on the meds. I've got a couple of sites with meds info which i'll dig out when I get back.

i just didn't want you to go unanswered, although I'm sure someone will be along soon with some advice

Sorry, don't know about sertraline during pregnancy but do know that I was specifically prescribed it when breastfeeding (the consultant wanted me to stop bf and start medication, I refused, we compromised with sertraline and continued bf). So maybe it's okay during pregnancy.

What I understand is that it's hard to do research on pregnant women so thery don't know, but there's no reason to think you'd miscarry - BUT obviously I'm not a doctor!

Hope you get the appointment soon

ps, i was prescribed it as it's one of the better ones for breastfeeding. I need to phone my psych to discuss going back on it, so i'll do that later and see what he says.

Thanks everyone so far - it makes such a difference to have some contact with lovely people who know what I'm on about - feel very misunderstood most of the time! xx

yeh they put me on that one while i was pregnant with ds so i guess they think its fairly safe 4 the baby. didnt do nothing for me but thats not the point...

Hearts, I've been on 100mg sertraline for 15 years now, throughout my healthy pregnancies and breastfeeding and NOT ONE specialist doctor (in three European countries) has EVER said sertraline is harmful to the unborn baby. Also, all specialists I have seen(and believe me, there are many) agree that pregnancy is usually not the best time to go off this kind of medication. Surely, if you ask your GP, s/he will say the same mantra all-medication-bad-leave-it, how often are they really capable of -or even willing to- measure the risks and benefits of any special medication.

Aiti72 - that's really encouraging..Had a really bad night last night so thinking of just going for it.
I did notice weird withdrawal symptoms when I finished weaning off - did your babies have any problems with "withdrawal" when they were born?

Hi Hearts, no withdrawal symptoms, healthy and well feeding. Take care of yourself there now.

Hi, I am a psychiatrist and do prescribe ADs for pregnant women at times. In general, I try to hold off until 12 weeks if poss and prescribe fluoxetine as there is more evidence that it not harmful. I also advise if possible to withdraw the drugs slowly a few weeks before due date to avoid withdrawal symptoms in the baby.

However, sertraline passes the least through the placenta and the least into breastmilk. For breastfeeding mothers I recommend sertraline.

Have you tried CBT? Evidence shows as effective as ADs. I think you can request rapid access to a psychologist as pregnant.

This is the general advice I give, but obviously different patients require different approach.

Hope this helps

I took sertraline from 12 weeks pregnant with DD and breastfed her until she was 10 months.

She didn't seem to have any "withdrawal" problems and was (and is) a healthy and happy child .

Oh, Hearts! Here's hoping you see the consultant soon. I know how it goes. Want a panic attack buddy?

K, AP, that's the issue I'm facing.

I have not only antenatal depression but also postnatal depression.

Every time.

I cut my dosage of fluoxetine down when I found out I was PG, to 20mg.

Am now 11 weeks and really struggling with panic attacks and depression. Not good. Midwife even noted it at booking in.

But now, if I take fluoxetine all during the pregnancy and I plan to BF, can I still take the fluoxetine? Or need to wean off and then get onto sertraline.

There is NO question of my weaning off ADs after the delivery for some time - I have already had two severe cases of PND, the second time on a more restricted dose of fluoxetine, and would really like to avoid that again.

that's good to know, Idris.

Ex-pat in scotland - if you are on fluoxetine throughout your pregnancy it is probably best to continue with it throughout BF. But talk it through with your psychiatrist.

Now I'm going to be worried about my baby being screwed up by ADs.

These damn panic attacks are doing my nut!

Like Hearts, I'm waiting for my consultant appointment.

Maybe he'll switch me. I'm on a pretty low dose right now and I hate how hard it is for me to 'surface' in the morning. I'm in such a fog.

And since I have insomnia and panic attacks and can't take my temazepam it's the last side effect I need.

hearts, sorry I didn't get back to you yesterday. I'm waiting on my psych getting back to me!

expat, I was put on fluoxetine for AND when I was 30 weeks with DD, but the consultant on the PN ward thought it better to come off it as it does pass through into BM. They put me on......seroxat (?), and said no tabs for a week before starting the new ones. A very tough week for me with post birth hormones raging . anyway, I had my first psych appointment at the neo-natal unit the day after i started the new drugs. His immediate thought was no to the seroxat as well and prescribed sertraline for me. DD has always been bright as a button and didn't have any withdrawal symptoms from me stopping the prozac. For me, it seems to be working as well as the fluoxetine, although I'm not sure about panic attacks. I stopped it when I thought I was pregnant, but think I'll be better back on it as soon as possible.

Anyway, I've been away for a bit, and you were in the middle of waiting for the hospital to find your test results so you could get a scan. I take from your post that all was well . I haven't had a can yet, but heard the baby's heartbeat at my booking appointment!

It is important to remember that there are risks associated with NOT treating depression as well. Untreated depression is associated with infants having a lower weight (not at birth, but in the weeks after) and delayed language development in later years.

thanks for the input, daisy!

i'm on such a low dose right now, it might be more feasible for me to switch. i'll bring it up with the consultant.

i can't take any of my anti-anxiety drugs, anyhow, just now.

but it's getting to where i had to pull over in the car today due to panic attack.

yes, scan went well! 9 week old foetus seen very well on abdominal scan a fortnight ago, so nuchal will be a week from today.

saw midwife on tuesday and gave her two vials of blood - still got the bruise - but more to come for the nuchal.

they're trying to arrange it so i can see the consultant same day because as you know we are very rural and the trek into Paisley is not a short one.

tbh, i'd rather switch now than after the birth because, well, you all know how bad i get after the births!

it's manageable right now. sort of.

that's very interesting TAP. Is that because a depressed parent is less likely to interact with their child than one who isn't?

That's the theory - but it's not been proven why exactly

That's great . I'm not bothering with a nuchal or any Down's testing at all....I would just worry too much about the results so we are taking things as they come really.

I get panic attacks as well, so understand your pain. they've been getting worse over the last few weeks too .

I just bloody wish I could put it all behind me and feel normal, without the need for drugs.

doesn't it suck, though, daisy?

sometimes i think, 'why me?', you know?

but then, why not?

it's funny, the chap i went out with before moving here is now a neurosurgeon. and he has bipolar disorder. and though when we were together i tried to understand, of course i couldn't.

after i had DD1, he got in touch.

i felt like he was the only one i could tell how i really felt. i felt so alone, so shut down and numb and death seemed like a constant companion and a not entirely unwelcome one - this was pre-MN for me .

how he phoned me and told me, 'i'm really sorry you had to find that out.'

i mean, what else is there to say?

i hope you get some answers, Hearts, feel free to post on here anytime!

you are not alone.

I was on fluoxetine to start off with but then switched to sertraline, DS very happy, healthy 16 month old. We exclusively breastfed for six months and he self weaned at 9 months, never had any withdrawal issues for either of us.

Hope it all goes well for you and that they sort you out with meds to support you both.

Took seroxat all through my pregnancy with DS who is now 3 and a wonderful little boy! Am still on seroxat and am 32wks pregnant with a little girl, counsellor has recommended I switch to setraline but am scared of changing meds and getting really ill. Also another member of the panic attack club!

Not able to get on here very often but just had a chance to catch up - so nice that there's others out there. And some reassuring similar stories. I hope I can post a success story in due course....

And thank you to the Accidental Parent (great name) for professional input...I have my appointment to see psychiatrist on Weds am, so have tried to be brave & wait til then before taking anything.

Had a reasonable weekend but waking early every day, lying "agitating" and so very tired - and then that makes it all worse of course.

I have acupuncture tomorrow which I finid REALLY helpful but it isn't strong enough when I am this bad - great for that day and the day after but at £35 a session can't continue to do it on a weekly basis.....It really SHOULD be available as a treatment on NHS.....!