Antidepressants and Pregnancy: your story

[thingamajig]

I want to do some research into this area, I am a Pharmacology graduate and have the prospect of some funding to find out more. I have a bee in my bonnet about the way a lot of women are taken off their ADs or changed to a different one and the consequences that has. Often there is no proof that staying on the same one would do any harm to the baby.
The other concern I have is the lack of information available about the effects of different ADs in pregnancy and breastfeeding.

I am on a high dose of citalopram, which I stayed on (and increased) during my pregnancy. My midwife believed that I should be moved onto sertroline, my GP didnt know, My psychiatrist didn't really either, but thought that the balance between the benefits to me and the risks to the baby should be thought through. I asked the midwife to get the pharmacist at the hospital to look up the relevant facts. If I hadnt persisted I would not have got this information. Much the same story on the question of breastfeeding.

A couple of friends of mine have not been so well treated, and it has caused them a lot of pain and suffering at a very emotional time in their lives.

I was wondering if you could help me and what thoughts you had on these issues, and what your experiences were. This will help me see if this is a wider problem. Specifically, I would like to know:
-what AD you were on pre-pregnancy
-what you were changed on to (if applicable)
-who made this decision (GP or psychiatrist etc)
-whether you remained well mentally throughout pregnancy and breastfeeding.
-anything else you would like to add.

Thank you, I really want to do something useful in this area.

I take Lofepramine for what is now clearly SAD (after a few years to sort myself out and not being depressed Feb-Oct consistenly for over a decade).
Friends referred me to a certain GP when I moved to this area as being good on mental health. He figured that one could do much worse than take it during pregnancy especially seeing I'm a non-smoking otherwise healthy adult, and when he found I had background in neuroscience told me to look up the research myself. Which I did and despite it being a drug from the 1960s there are no reported ill effects from taking it in pregnancy, except a few anecdotes where the mother was also a heroin user. So he told me to go for it (especially after I tried to not take the pills one winter while ttc and it was Not Good.)

There was reearch done to show how almost none of the drug gets into breastmilk, so that was good - an advantage of an ancient drug.

Just after ds was born I changed GP (to practice next to my house where MrNC and ds were registered), and despite asking wtf I'm taking such an old drug for, they've been great (I started it just before Prozac etc were licenced in the UK and don't want to change given the side effects SSRIs all seem to have. I keep wondering why they push SSRIs so much and then remember the big catch with tricyclics - it's easy to die if you overdose. So docs cover their backsides and prescribe the ones that give people stomach cramps).

Started taking it again when ds was about 2 months, after a lot of arguing to get breast thrush treated properly and other stress and me going "no I'm not depressed, I'm just miserable!" and then a couple weeks later "OK now I'm depressed, pass the pills again"

Had the odd query from midwives etc about taking them but always in a questioning fashion not judging, and on explaining that research says OK, no problem. I had a lot more grief about getting flucanazole for thrush and bf and eventually had a 30-min argument with GP which included me going "Yes actually I do have a doctorate on breast development and milk production in pregnancy, if we're boasting about our relevant qualifications..." (true, but impolite ... but I got the drugs and sorted out bf and continued for another year. )

When I told my pschologist I was ttc, I was encouraged to change from Citalopram which I've been on and off since the birth of my son 5 years ago. I manage pretty well on it, and always sink when I try to come off. Anyway, I tried Prozac which my psych said was better for pregnancy, but it did nothing for me and if anything, made me more anxious. So I went back on to Citalopram, and then conceived a few months later.

When I found out I was pregnant I was encouraged to lower my dose from 20mg to 10mg by the doctor, which I tried, and managed for a while, then sank in to anxiety. So I've now upped to 20mg again, and have been for 4 weeks, but still don't feel any better. I think that had I not been encouraged to drop my dose (with a view to coming off) and experienced all the judgements from the midwives and doctors, then I might not be as bad now. I think doctors think you're just lightweight and don't seem to consider that of course you'd rather not be on the pills, in pregnancy or any other time, but that you have no choice. It's not as if I haven't half killed myself trying.

Now I just feel extremely anxious and panicked, and worse than ever. I'm hoping it's the hormones and that it will get better...

Have been on fluoxetine 20mg at the start of all three pregnancies which has been stopped by 12 weeks, last pregnancy was pretty bad towards the end and I started taking them again when DS was 7mths old.

Am currently 31wks and suffering v bad anxiety/OCD type sypmtoms (which is why I took the fluoxetine in the first place)

I can't start taking them again now as I always have a very bad first few weeks on them and am not willing to do that whilst pregnant.

I am very interested to see this thread, as I am currently on 40mg Citalopram and TTC.

My GP has said tht I am on the right medication if I am going to be pregnant and although it would be ideal to drop to 20mg she has said she will not pressure me, as the benefits of my mental health far outweigh any risks.

In fact, I inititally wanted to come off them totally and she talked me round. My GP is a wise lady and I trust her implicitly.

lilredwg your doctor sound's brilliant, im in the same boat but on 20mg and was told i need to come off them while we try ttc, the whole stress of it all infact as resulted in my anxiety to start again so i need to go back and maybe get them increased, im sure she will just tell me to wait to ttc like she did last time :-(

I was off ad's prior to pregnancy with dc1

Went on them after she was born for PND. First imipramine (too tired on it, didnt work), then sertraline (great).

Stayed on sertraline through pg with dc2 and 15 months bf, till I found out I was (very unexpectedly) pg with dc3. Still stayed on them. Decision made by psychiatrist.

Was on them till dc3 was 17 months when I had a severe reaction to them (serotonin syndrome) and landed in hospital for several days. Was taken off them, and was great!!

I have to say that the thing that really kept me mentally well with dc3, my worst PND episode (and I undoubtedly had AND as well) was therapy - I was lucky enough to encounter a psychiatrist who was also a skilled psychotherapist (they don't always go together lol) and I think that that had as much to do with my recovery as the tablets - it dug out some very deep seated problems!

Hi there this is an old post and I'm not sure if I'm posting in the proper place. This thread has been really useful to read. I'm in a difficult position where my psychiatrist is forcing me to come off medication because we would like to have a baby. He says that as I've been well for last 2 years I should come off everything gradually - I currently take paroxetine and chlorpromazine for anxiety panic attacks and depression. This medication has helped me immensely and in the strongest possible terms do not want to stop taking medication. This medication keeps me well and I have never been able to not need it. Every time I have attempted to stop taking medication i have relapsed with devastating consequences. I work hard to stay well and don't want to go back to how i have been in the past. Has anyone any advice? I'm thinking about getting a second opinion.

noe sort of same boat as you, but I didn't decrease my meds (20mg citalopram) until I was actually pregnant (dropped to 10mg). The first trimester was awful but I got through, second trimester has been a breeze. Docs want me off altogether by third trimester (3 weeks from now) and to be honest, it's the last thing on my mind. My top priority is my mental health, I cannot have a healthy pregnancy/labour/newborn without being stable. My midwife also agrees with me and hasn't put pressure on to come off altogether. If you can get a second opinion, great, but if you know deep down that coming off/reducing is going to end up with you suicidal, then don't do it. However, all said and done, I am not a doctor and whilst I'm familiar with paroxetine, I've not heard of chlorpromazine before and don't know what the effects on a foetus would be.

Thanks for your quick reply! Did your dr or psych force you to reduce meds? It horrifies me that they could do that. I need to be well also - I want to have a baby but it scares me too which is enough to deal with on its own and now the added worry of getting unwell as well...

There's limited research on both medications I take that might suggest risk to baby. Chlorpromazine is an antipsychotic used for anxiety. I would agree to changing both to something known to be safer but psychiatrist won't agree to that. Says I must be treatment free but will treat if get unwell. Point is I don't want to get unwell again in the first place or even risk it.