Lexapro during pregnancy and PPA

Jules122907

Has anyone been taking Lexapro during their pregnancy? I have had PPAnxiety after each of my previous births and expect to deal with it again after this delivery. Lexapro has worked best for me in the past. At my appt yesterday, my OB suggested possibly starting to take it 2-4 weeks prior to my scheduled csect to let it begin building in my system.

At the same time, she cautioned me that some of the medicine could possibly reach the baby and that some babies experience withdrawl symptoms after birth. But, that is usually only for babies whose moms took it throughout their pregnancy instead of just late 3rd tri. She wrote the prescription and told me it was my choice when to start taking it.

I'm doing some online research, but am wondering if anyone has personal experience.

Warding off the severe, disabling anxiety attacks I had in the past with two little ones and a newborn in the house has its obvious appeal but I'm torn on what is best.

Jenball717

I personally didn't think it was worth the risk during pregnancy. Did your doc mention anything about starting it immediately after birth and taking Xanax when an episode hits until the medication is in full effect? I did that for a while when waiting for Lexapro to take effect once and it worked pretty well.

Jules122907

No, she didn't say anything about filling in with the Xanax. I will ask about it! Thanks!
I started the Lexapro immediately after my second csect and it took me about 5 wks for enough to build in my system to take care of the attacks completely.
My csect is scheduled at 39wks. I'm not willing to start taking it at 34wks with this pregnancy, but am considering starting at 37 or 38 wks.

CousinVicki

yes take it NOW, as your Dr suggests, or at least 4 weeks before birth.   it needs to build up. 

i took it my ENTIRE pregnancy, yes, i said entire, with my son, and there was no withdrawal symptoms, and am taking it now, same deal.  lowest dose, 10 mg.   I am still having anxiety, but it's lessened.   and there is no way in F i am going to risk PPD.  nor am i going to take xanax while bf'ing until the meds 'kick in'  , come on!  

   i have said this before, but it's advisable to start taking it third tri for the reasons you said, don't you want to be a functioning, present mom?  this far outweighs any risks (which, are nominal especially starting so  late).  if you don't believe me see a psychiatrist, preferably who specializes in pregnancy if you can find one.  

ETA: sorry for the rant, but so many people are so scared of meds, when they really need them. ugh

Jules122907

I am not able to breastfeed, so meds after birth are not an issue. Also, I am not against meds because I know I need them but sources like the one below make me hesitant to start taking them now when I have never taken them during pregnancy. PPA sucks and it is awful knowing what is ahead of me after giving birth. I've dealt with it after the birth of both of my other kids. But, I have a strong support group in place and my mom and aunt have the ability to be with me for extra help for the two months after the birth. Thanks for sharing your experience!!

https://americanpregnancy.org/medicaction-pregnancy/escitalopram.html (mobile so it may not be clicky)

"Neonates exposed to Lexapro and other SSRIs or SNRIs, late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Such complications can arise immediately upon delivery. Infants exposed to SSRIs in late pregnancy may have an increased risk for persistent pulmonary hypertension of the newborn (PPHN)."

Jenball717

I'm also not anti med but I know from previous posts that CV and I have different ideas concerning medicating while pregnant.

I needed to go on Lexapro last year after a car accident sent me into a depression and anxiety ridden state and my husband and I had been planning to get pregnant around the same time. I waited until I could be completely off the medication to get pregnant because of the classification of most ssri's, including Lexapro.

Given that the full risk to a fetus is not completely known at this time, I felt it wasn't worth it. If anything were wrong with my baby I would always have that nagging doubt in the back of my head, if I had something to do with it.

Yes, mother and child both need to be taken into consideration when a decision like this is made, but if there is a safer route, why not opt for it? I prefer to go conservative when it comes to medication.
Good luck finding the best option for you, though!

Amjoy25

Jules122907 said:

I am not able to breastfeed, so meds after birth are not an issue. Also, I am not against meds because I know I need them but sources like the one below make me hesitant to start taking them now when I have never taken them during pregnancy. PPA sucks and it is awful knowing what is ahead of me after giving birth. I've dealt with it after the birth of both of my other kids. But, I have a strong support group in place and my mom and aunt have the ability to be with me for extra help for the two months after the birth. Thanks for sharing your experience!! https://americanpregnancy.org/medicaction-pregnancy/escitalopram.html (mobile so it may not be clicky) "Neonates exposed to Lexapro and other SSRIs or SNRIs, late in the third trimester, have developed complications requiring prolonged hospitalization, respiratory support, and tube feeding. Such complications can arise immediately upon delivery. Infants exposed to SSRIs in late pregnancy may have an increased risk for persistent pulmonary hypertension of the newborn (PPHN)."

While I would not cite American Pregnancy, you totally disregarded the info on this site that was of value:

Briggs, Freeman, & Yaffe – Human pregnancy experience with escitalopram is very limited. The animal data suggest that the risk to an embryo-fetus is low. Two large case-control studies did find increased risk for some birth defects, but the absolute risk appears to be small.

Physicians’ Desk Reference –There are not adequate and well-controlled studies in pregnant women; therefore, escitalopram should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Reprotox Toxicology Center – Based on experimental animal studies and human reports, standard therapeutic use of citalopram or escitalopram is not expected to increase the risk of congenital anomalies.

CousinVicki

sigh.

losersaidwhat

I started Zoloft for anxiety only yesterday and had the same concerns (it's all the same with SSRIs) but ultimately I feel the benefits of getting a jump on treatment outweigh the risks. My doctor reassured me that although the possibility of my baby experiencing some withdrawal like symptoms is there, the main concern tends to be when you take it during the 1st trimester during such a crucial development period. By this point in 3rd tri your baby is fully developed and is just packing on the pounds so to speak - taking a low dosage starting now won't generally have an effect on development.

Adjusting to a newborn is hard enough without throwing a new medication adjustment into the mix.

FWIW I took Effexor for PPD/PPA with DS2 but the anxiety started for me much earlier this go around. I was going to try counselling/therapy before jumping straight to meds and first brought how I've been feeling up with my doctor a month ago, but couldn't get an appointment until late September(!) and couldn't cope anymore on my own. I can't imagine going through this hell with a newborn around.

lovelittlebean

I have been on Zoloft my entire pregnancy, and for 3 years before getting pregnant. I am on a lower dose now and plan to increase it postpartum. My Dr. said it was better to be on medication than to have panic attacks and depression. I have had close monitoring and several ultrasounds to make sure the baby is developing normally. So far so good!