pregnancy and deppression/anxiety?

[xkatyx]

Hi everyone,

Me and my husband desperatly want a 3rd baby, im currently on citroplan 20mg and plan to come off them very soon and doctor is also happy for this.

I'm just worried about the anxiety mostly getting out of controll if i fall pregnany, i know during my period the anxiety raises slightly and also remember in my last pregnancy i was very nervous and panicky all the way through (wasn't on any medication at all)

So really i was woundering if anyone has any personal exsperiences from this? and what help they recieved or self help they tried.

thank you

Hi Katy
I am currently pg with second, much wanted DC. Like you i suffered from quite severe antenatal depression with DS 1 and unfortunately things have gone the same way this time and I am currenty struggling through every day

Last time i managed to avoid taking meds during pregnancy as the depression lifted at around 16 weeks. Am currently 12 weeks and i would say worse than i was at this stage last time so am not feeling very optimistic about how things will go this time.

My GP's stance is that if the depression persists the benefits of treatment will outweight any risk of harm, especially now i am at the 12 week stage. I tend to agree and will go for it in the next few weeks if things dont get better, partrly due to the fact that it is having an effect on my DS (nothing huge as I am reasonably good at putting on a 'face' but he has picked up on my feeling 'poorly').

There are a lot of antidepressants that have been around a long time now and so more/a lot is known about how safe they are in pregnancy (a lot of women taking AD's get pregnant!!). I am not sure about citalopram specifically but my GP metion fluoxetine and said that is thought to be safe.

I think its really really important to get help via other means as well, and I would be surprised if your Gp wouldnt refer you for some counselling support if and when you8 do fall pregnant. they should be able to help you with things like relaxation etc which might help.

All the best

This is quite interesting on fluoxetine in pregnancy

Please note: The following paper was just published concerning Fluoxetine and breastfeeding. They suggest the relative infant dose was 2.4% to 3.8% of the maternal weight-adjusted dose at 2 weeks and 2 months respectively. This is slightly less than others have published.

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Clin Pharmacol Ther 2003 Apr;73(4):330-7

Pharmacokinetics of fluoxetine and norfluoxetine in pregnancy and lactation.

Heikkinen T, Ekblad U, Palo P, Laine K.

BACKGROUND: The aim of this prospective clinical trial was to investigate the pharmacokinetics of fluoxetine and its active metabolite, norfluoxetine, during pregnancy, delivery, and lactation in mothers and their infants. METHODS: Eleven mothers taking fluoxetine and their infants were enrolled in the study. A control group of 10 women who were not taking psychotropic medication were prospectively matched for confounding obstetric characteristics at the time of delivery. Trough plasma samples and breast milk samples were collected from mother-infant pairs during pregnancy, at delivery, and up to 2 months after delivery in the fluoxetine group. The pregnancy outcome was recorded, and the growth and neurologic development of the children were followed up to the age of 1 year in both study groups. RESULTS: The fluoxetine dose from 20 mg to 40 mg once daily resulted in relatively low trough fluoxetine-norfluoxetine concentrations during pregnancy (range, 317-850 nmol/L). The mean norfluoxetine/fluoxetine metabolic ratio was 2.4-fold higher during late pregnancy than at 2 months after delivery (P =.0072). At delivery, the infant plasma fluoxetine and norfluoxetine concentrations were 65% and 72%, respectively, of those found in mothers. The mean estimated infant exposures from breast milk to fluoxetine-norfluoxetine were 2.4% and 3.8% of the maternal weight-adjusted daily dose at age 2 weeks and age 2 months, respectively. The pregnancy outcome, as well as the growth and neurologic development of all infants up to 1 year of age, was normal. CONCLUSION: Common clinical doses of fluoxetine resulted in relatively low concentrations of fluoxetine during pregnancy, which can be explained at least partly by increased demethylation of fluoxetine by cytochrome P450 (CYP) 2D6. This might indicate that these low blood levels could lead to therapeutic failure, and clinicians should be alert to this possibility so that depression in pregnancy is not undertreated.

Hi there. I suffered ante-natal depression with both of my pregnancies. They wanted me to take medication with my second but I refused. Instead I opted for the Mental Health Team to be my support. I was assigned a Community Psychiatric Nurse who would visit me every week to see how I was getting on. I also had an emergency number to ring should things overwhelm me, my husband could also ring them on my behalf if he was worried about me, which he did twice.

A lady came a couple of times to work with me on relaxation techniques but I never really did get on with that, it might work for you but I'm just far too uptight to relax!

I also read an article in a newspaper yesterday praising the benefits of acupuncture for depression in pregnancy.

Now that ante-natal depression is widely recognised, there are a number of treatments available, from medication to counselling and relaxation. You just need to find the right one for you. Have a word with your GP and see what he recommends.

I would say that if you do try without medication, expect a tough ride. It can be done but it's very hard on you and your family. My second pregnancy was hell on my daughter and if I were to go through it again I may consider medication.

you might find this website helpful

The best thing I can suggest is to talk to your doctor. I was on fluoxetine prior to falling pregnant and my doctor was able to advise an alternative medicine that posed a very low risk in pregnancy. The postnatal depression team have also been made aware of my position on a purely "just in case" basis, which is a nice safety net to have.
Obviously, nobody can make the decision to come off ADs except you but don't feel bad if you feel you still need to take them. As other people have mentioned, a doctor will always weigh up the relative risks before prescribing anything during pregnancy, so the only thing you can do is to talk to him about how you're feeling and trust in his advice.

Hope you work it out

Hi thank you all for the information, i did talk to my doctor unfortunetly they said to come off the med'sn:-( which i really dont want to do. I feel great at the moment but like i said when my period is due the hormones from that alone start the anxiety off, so i really am worried about being pregnant and not being on any tablets :-(

Then get a second opinion - is there another doctor in the practice that you can see? Explain to your doctor that you are worried, explain what happens every month. The doctor might just think that you'd be happier without and it's best for the baby, he might think you've gone away perfectly happy about that. You need to speak out.

At the very least ask him to refer you to a CPN who will talk your worries over with you and who will be there for you should you need them.

That seems strange to me. I said virtually the same thing to my doctor and got the above response! I suppose you can't bank on the compassions of different doctors... Is there another one you could see? As I said there are other medicines which are deemed safe in pregnancy - there's no reason why you should be denied them if you begin to feel you can't cope, or even as a preventative measure (as in my case).

Hiya. Am pregnant with DC4 at the mo, and like you suffer from anxiety. I have never had it when pregnant but always when my babies hit 3 months, then it spirals and continues; also hideously bad around ovulation and before period due. This time, however, I am having big time anxiety in pregnancy. I am currently on a one to one for CBT and it is proving to be helpful. Who knows, maybe this means I will have no anxiety after the birth!!
I think I answered your thread regarding CBT, so maybe this is a good option for you? Try to make sure that it is one on one; very much more in depth that way. Good luck!

Hi catbus i think i was hoping for someone to say " oh i had a great pregnancy no anxiety whatsoever" lol wish for thinking though , i think i know it's going to be a struggle and i am dreading it!! but i will go see another doctor best bet really and hopefully he will tell e what i want to hear i suppose.

But i am looking forwRD TO the CBT im really hoping it will help :-)

I totally understand I am 18 weeks, and had group therapy for ocd since july, which i am not sure if i am any better, certain areas are but some are far worse! I am starting cbt next week one to one, for my depression and phobia! so fingers crossed once they are sorted my anxieties will come down

Recently i discovered meditation which has really helped and the children do it as well! my eldest is 7 and staying with mil, so we are going to have a phone call later for guided relaxation! i have found it so nice to do it with the children and feel we connect whilst doing it

I was on medication until about 8 weeks pregnant, but started to wean my self off about 6 weeks, I would def say get off them before you get pregnant, as i found it even harder to battle the side effects and the first few months of pregnancy together!

Good luck with the CBT , well donr for getting off your tablets. I honestly dont think ill be able to cope with out them. My oregnancy last time was just horrible i dont want to go through that again.

I was on 5MG of ADs (Paroxetine, but they're all SSRIs - drive up Serotonin levels)....and was advised to wean myself of them in the 3rd trimester (about 30 wks). this proved a bad move as I started feeling really anxious and down...not really wanting to have a baby if it was going to make me worry so much about how I'd be when it was born.

I am now 9 days overdue (!!!) and back on 20MG and I have never felt bettter. I've had opinion of 2 midwifes, my GP and a paediatric consultant and all say the benefits far outweight the cons and the risk to baby is minimal and I can still breastfeed.

I have also had hynpotherapy which uses relaxation and Cognitive Behaviour techniques to stop the worrying cycle I'd really recommend it.

Obviously it's personal choice but I wouldn't worry at all about taking medication..or feel pressured in to coming off something by someone, medical professional or otherwise, who hasn't experienced depression or anxiety themselves and can't possibly understand how completely debilitating it can be.

Good luck everyone and I hope you find what works for you.

mc76 yeay a positive story thamk you, im so glad its working for you.

9 days over due, good luck, please let us know how you get on xx

Thanks, yes 9 days over not good for an anxious person but my hypnotherapy techniques are really helping and my tablets of course......and it can't be that long now till baby arrives!!

So exciting, i wish i could just jump to that stage lol

Hi, I am 18 weeks pregnant with my first baby and I am taking venlefaxine for anxiety and depression. I went to see a private psychiatrist who reccomended I go on this medication as I was severly anxious and depressed. I've been on them for about 2 years now and feel great. I told him that my partner and I wanted to have children in the future and I was worried about coming off the tablets to do so. He told me that there was no need for me to come off them and that there has been no evidence of them harming the baby. He said that women with other conditions such as diabetes have to take medication through their pregnancies. He also said that if I was to come off them and get anxious and depressed again, then that could be harmful to the baby. So we started trying for a baby last August when I felt 100% better and ready and I caught 3 months later. I always thought that I would be an anxious mess through pregnancy but I have been fantastic! Apart from recently suffering a massive bleed and discovering I have a low lying placenta! But my point is that sometimes women have to take certain medications through pregnancy and its ok. I hope everything works out for you and remember that you are not alone, there are lots of women who have gone through or are going through the same thing. Lots of luck xxx

thank you so much gems12345 so pleased to hear a positive story and glad you are having a happy pregnancy.
how do you go about seeing a psyhiatrist?

I'm 14+5 in my first pregnancy and have been depressed most of my adult life. Was on 20mg citalopram, and had just cut down to 10mg when I got pg. I then cut down at about 8wks to 10mg every other day. Came off them totally at about 10wks.

My docs and mw have been totally happy with that, and baby is doing fine. I was initally referred to the high risk antenatal clinic, but they have dishcharged me and I'm back to full mw led care. I've also been offered the help of a mental health midwife, but so far have not felt the need. In the last week or so I have been wondering if the depression is coming back, but I think it might just be hormones, am keeping an eye on myself anyway.

It can be done, I promise!

Congratulations on your pregnancy cosmosis
well done for getting off your med's, must of been really difficult.

I had to go private because the waiting list on the NHS was something ridiculious like 2 years!! I went through spire hospital and only needed to go twice and although it was expensive, it was 110% worth it! I think it cost around £250. But he put me on fantastic medication that gp's dont like to perscribe to you because it is expensive. I have been on citalipram in the past and didnt find it helpful at all. I did some research and found out that citalipram costs the NHS just over a pound a month for you to be on and venlefaxine costs around £30 a month so its no wonder gp's dont tell you about it! xx

Oh really, that is interesting. so you rekon i should ask my doctor to be refered to one? if not try get a private one? x

Yeah I think so. I would ask your doctor how long the waiting list is as well and if you can't wait that long and you can afford to go private I would do that. I was very lucky in that my partners dad paid for me to go private, otherwise I couldnt have done it as I was off work and just recieving sick pay. I hope everything works out for you Good luck xxx

Thank you gems1234 i think i will defenatly have a look into that. after all it would be great to talk to a doctor who knew what they where talking about and could reassure, after all just the reasurance would help so much better with the anxiety.