TTC and antidepressants

Pacty49

Please forgive me if I'm posting in the wrong place, I'm still new and learning! This board seemed the most appropriate for this but I will be happy to move if necessarily...

Also, first, disclaimer...I know this is something to talk to my doctor about, and I plan to!! I am not seeking medical advice, just asking about personal experiences before I get in to see my doc, really just out of curiosity. 

I am on Prozac (80mg) and Lamictal (200mg) for depression and anxiety. I have been on them since I was a teenager, about 12.5 years now. Just wondering if anyone had any experiences with TTC on those specific meds or any antidepressants. Did you have to wean off them first? Did you take them throughout your whole pregnancy? Most of the things I read say they are safe, but I'm not sure how I feel about it. (We have not actually started TTC yet but plan to soon). 

Thanks ladies! 

heatherdubrow

I weaned off welbutrin before starting my FET process, but I don't have any experience with those particular meds. Definitely talk to your dr.
Also, there is a mental health check in thread that you should check out.

jenotontx

@Pacty49 I am a mental health therapist (not an MD) and I have worked with several patients in your position. The one thing I can say is that there is certainly not a one size fits all approach to antidepressants and TTC. Your doctor will likely take into consideration your history of anxiety and depression (how chronic it has been and how severe) to help you determine if you should remain on antidepressants or not. Just remember that you are in control of your treatment! I would never recommend for someone to ignore their doctors recommendations but I would always suggest a second opinion if in your gut you feel uncomfortable with what those recommendations are. I would also highly suggest therapy (if you aren't already doing that) if you do decide to go off meds because having someone that can monitor you more frequently then a doctor, can make a huge difference. 

Wombella

Hi, 

This was such a big question for me before I started TTC that I actually made it the topic of my thesis in grad school. You should talk to your doctor, but be sure you talk to your psychiatrist as well as your OBGYN. The most important thing is understanding your specific risk for depression during pregnancy and postpartum. They may not be worth the small risks of birth defects that are possible if you are unlikely to have an episode of depression or suffer from panic attacks while you are pregnant. If you are like me, the chance of becoming depressed during pregnancy is pretty high, and the baby would be much healthier if I stay on medication (Lexapro) than if I went off. Good luck!

izza2

Pacty49 said:

Please forgive me if I'm posting in the wrong place, I'm still new and learning! This board seemed the most appropriate for this but I will be happy to move if necessarily...

Also, first, disclaimer...I know this is something to talk to my doctor about, and I plan to!! I am not seeking medical advice, just asking about personal experiences before I get in to see my doc, really just out of curiosity. 

I am on Prozac (80mg) and Lamictal (200mg) for depression and anxiety. I have been on them since I was a teenager, about 12.5 years now. Just wondering if anyone had any experiences with TTC on those specific meds or any antidepressants. Did you have to wean off them first? Did you take them throughout your whole pregnancy? Most of the things I read say they are safe, but I'm not sure how I feel about it. (We have not actually started TTC yet but plan to soon). 

Thanks ladies! 

First off - welcome to the board!

As for the question at hand, I was weaned off of my antidepressant when we were TTC previously and I will be weaned off of the antidepressant once we get closer to TTC again.
My depression is stable. That's my plan with my physician.

Others, as they've said, would be better staying on their antidepressant throughout TTC and pregnancy.

When you talk to your physician, bring up your concerns and make sure they are talked about. If nothing else, you can wean the dosage a bit and see how you do while not TTC before making any definite decisions.

NYTino24

@heatherdubrow I didn't start one this week... so feel free to copy last week's and repost! 

Pacty49

Thanks ladies for all of the responses

anj042014

izza2 said:

First off - welcome to the board!

As for the question at hand, I was weaned off of my antidepressant when we were TTC previously and I will be weaned off of the antidepressant once we get closer to TTC again.
My depression is stable. That's my plan with my physician.

Others, as they've said, would be better staying on their antidepressant throughout TTC and pregnancy.

When you talk to your physician, bring up your concerns and make sure they are talked about. If nothing else, you can wean the dosage a bit and see how you do while not TTC before making any definite decisions.

Hi all. I'm new here as well. @izza2 what do you do to help keep your depression in check. I've weaned off of my prozac and will hopefully be getting weaned off of my Wellbutrin this year before we start TTC seriously. I want all of the chemicals out of my system and to feel better because of some of the side effects. I've actually been doing well off of the prozac but sometimes my anxiety still rears its ugly head. So I was wondering if you had any tips or things that work for you. Thanks!

mschanandlerbong1214

@Pacty49 I was on those same meds when I conceived my second. We had a birth control fail so he wasn't planned but if he had been I would have been weaned off the meds prior to getting pregnant. Stopping those suddenly, especially the lamictal, isn't advised and they are not safe for pregnancy. I was ok but I can't speak for you because you've been on it longer than I was. This is definitely something to bring up with your OB as well as your psych so you're all on the same page. Oh and welcome! 

vlagrl29

Not normally on this board.  I have history of anxiety and use to take Ativan as needed before we began TTC #1 in 2010.  The pregnancy actually made me very anxious and depressed so the OB suggested zoloft and I stayed on it the entire pregnancy - no issues with baby.

izza2

AshleyE0708 said:

izza2 said:

*snip*

Hi all. I'm new here as well. @izza2 what do you do to help keep your depression in check. I've weaned off of my prozac and will hopefully be getting weaned off of my Wellbutrin this year before we start TTC seriously. I want all of the chemicals out of my system and to feel better because of some of the side effects. I've actually been doing well off of the prozac but sometimes my anxiety still rears its ugly head. So I was wondering if you had any tips or things that work for you. Thanks!

Counseling/seeing a psychiatrist if you aren't already is always a huge help. They help with more than just having a conversation and talking about your problems. They'll help you find ways to cope with stressors and issues that can and will happen in life, and they'll work through scenarios to figure out what you're doing that may be making the situation worse, and what you can do to help get through it.
Aside from that, I'm not sure. My depression has always been mild to moderate, and it's gotten better the older that I've gotten, so for me, weaning off could eventually turn in to a longer-term deal. That's not the case for most people, though.

mschanandlerbong1214 said:

@Pacty49 I was on those same meds when I conceived my second. We had a birth control fail so he wasn't planned but if he had been I would have been weaned off the meds prior to getting pregnant. Stopping those suddenly, especially the lamictal, isn't advised and they are not safe for pregnancy. I was ok but I can't speak for you because you've been on it longer than I was. This is definitely something to bring up with your OB as well as your psych so you're all on the same page. Oh and welcome! 

Are you saying stopping suddenly isn't safe for pregnancy, or the medications aren't safe for pregnancy?

The medications are a class C pregnancy drug, meaning that there is no concrete evidence that they cause problems to the fetus, but the risk cannot be ruled out. In other words - it's up to your physician and you on whether or not you should take them while pregnant.
For class C medications, it's a matter of whether or not stopping them will be more detrimental to the woman and her fetus than continuing them would be, when there's no "for sure" evidence that something will happen adversely while pregnant.

Please, for the love of God, do NOT go around telling people that class C medications are not safe for pregnancy. The last thing that needs to happen is people being told this and being adamant that they HAVE to stop their medications, when that can do a LOT more harm for their mental stability and the safety of themselves and those around them, than staying on the meds would.

LilLambie

**Dirty lurker**TW**

I took lamictal as well as another medication for epilepsy the whole way through my pregnancy. It was safer to remain on the medication, then to go off of it and risk a seizure. This was something my doctor and I decided, and I would definitely recommend finding a Dr (if you haven't already) who understands the medication and pregnancy. Lamictal was actually chosen because it is one of the safest medication avaliable during pregnancy for the treatment of epilepsy. 

My doctor (all this information was provided to me by my doctor, so again, consult your Dr) told me to start taking a high strength folic acid supplement before I started TTC as well as a regular prenatal, because this should counteract the increased chance of a neural tube defect. Pregnancy causes the lamictal to be processed quicker, so it became less effective. I was required to up my dose to maintain the same control. It also can cause issues with blood clotting for the baby, so for the last two months of pregnancy I took a vitamin K supplement. 

Again, talk to a Dr, but make sure it's one who understands pregnancy. My Dr moved half way through my pregnancy, so I started seeing a new one at 20 weeks. He didn't understand the medication and pregnancy and told me that the medication was dangerous (it's not) and I should quit cold turkey (stopping suddenly whether pregnant or not can cause serious issues). I ignored all his advice, followed the advice of my previous Dr and found a new one who couldn't believe what that Dr had said. 

I now have a healthy LO who hasn't had any ill effects from my medication. 

nursenat87

I've been on Wellbutrin for 5 years and it's been a life saver.  My OB told me not to get off it.  Though I'm sure it depends on the meds in question.  I don't know what category those drugs are in (I think both C - not enough research to rule out harmful effects). As others have said, best to consult with your OB and whoever is managing your psychopharmacology.  12 years is a long time so I don't have to tell you not to go cold turkey.  Talk to your providers and make an informed decision with all of them.  Untreated depression is also bad for babies. 

Hollyl321

I have obsessive compulsive disorder.  I have been on and off Zoloft in the past.  After having a MMC, my OBgyn pushed for me to take the Zoloft and continue it through out my next pregnancy.  

He was concerned how my stress and anxiety would affect me during pregnancy.

mschanandlerbong1214

izza2 said:

AshleyE0708 said:

izza2 said:

*snip*

Hi all. I'm new here as well. @izza2 what do you do to help keep your depression in check. I've weaned off of my prozac and will hopefully be getting weaned off of my Wellbutrin this year before we start TTC seriously. I want all of the chemicals out of my system and to feel better because of some of the side effects. I've actually been doing well off of the prozac but sometimes my anxiety still rears its ugly head. So I was wondering if you had any tips or things that work for you. Thanks!

Counseling/seeing a psychiatrist if you aren't already is always a huge help. They help with more than just having a conversation and talking about your problems. They'll help you find ways to cope with stressors and issues that can and will happen in life, and they'll work through scenarios to figure out what you're doing that may be making the situation worse, and what you can do to help get through it.
Aside from that, I'm not sure. My depression has always been mild to moderate, and it's gotten better the older that I've gotten, so for me, weaning off could eventually turn in to a longer-term deal. That's not the case for most people, though.

mschanandlerbong1214 said:

@Pacty49 I was on those same meds when I conceived my second. We had a birth control fail so he wasn't planned but if he had been I would have been weaned off the meds prior to getting pregnant. Stopping those suddenly, especially the lamictal, isn't advised and they are not safe for pregnancy. I was ok but I can't speak for you because you've been on it longer than I was. This is definitely something to bring up with your OB as well as your psych so you're all on the same page. Oh and welcome! 

Are you saying stopping suddenly isn't safe for pregnancy, or the medications aren't safe for pregnancy?

The medications are a class C pregnancy drug, meaning that there is no concrete evidence that they cause problems to the fetus, but the risk cannot be ruled out. In other words - it's up to your physician and you on whether or not you should take them while pregnant.
For class C medications, it's a matter of whether or not stopping them will be more detrimental to the woman and her fetus than continuing them would be, when there's no "for sure" evidence that something will happen adversely while pregnant.

Please, for the love of God, do NOT go around telling people that class C medications are not safe for pregnancy. The last thing that needs to happen is people being told this and being adamant that they HAVE to stop their medications, when that can do a LOT more harm for their mental stability and the safety of themselves and those around them, than staying on the meds would.

Wow. I was told, at least with the lamictal, that it wasn't safe, especially during the first trimester. I wouldn't KNOWINGLY propagate false information! Just sharing what my psych and OB told me. 

ETA - not trying to sound snarky at all! I'm generally shocked and now a little pissed that I was given false information. Kind of glad I left those doctors! 

vlagrl29

zoloft is a class C and I took it the entire 9 months - no issues

jenotontx

@mschanandlerbong1214 I'm honestly not surprised you were told that. That's why I always recommend numerous opinions (whenever possible) or someone who specializes in perinatal mental health care when it comes to these types of difficult decisions. I have worked with doctors within the same clinic that have very differing opinions and it can be extremely confusing. The truth of the matter is some doctors get scared and don't want their patients on meds while pregnant out of fear of lawsuit. On the other hand, as other people here have mentioned, going off meds can also result in more harm then good if the mental health concerns aren't being treated. So there must be a very individualized approach and consideration given to each person's situation.