TTC and Tapering off Anxiety Medicine

ashh2018

Hi all! I'm new here and have been trying to lurk a bit - tried to search for this and couldn't quite get the answers I needed. DH and I are planning to start TTC in the next month or two, as soon as I've tapered off of my anxiety medication. I currently take trazodone, sertraline, and clonipin (which I am definitely tapering off of completely before ttc).  I went to my ob/gyn on Friday, and she said to see what my psych said about the other options. Saw the psych this morning and she had no idea She flipped through a bunch of books while I came up with a plan on my own. My question is, is trazodone safe to remain on while TTC and through pregnancy? My instincts tell me no, but I'd love to hear some real life experience answers (since my doctor seemed like she'd never treated a pregnant woman before). TIA!

lulu1180

ah1982 said:

Hi all! I'm new here and have been trying to lurk a bit - tried to search for this and couldn't quite get the answers I needed. DH and I are planning to start TTC in the next month or two, as soon as I've tapered off of my anxiety medication. I currently take trazodone, sertraline, and clonipin (which I am definitely tapering off of completely before ttc).  I went to my ob/gyn on Friday, and she said to see what my psych said about the other options. Saw the psych this morning and she had no idea She flipped through a bunch of books while I came up with a plan on my own. My question is, is trazodone safe to remain on while TTC and through pregnancy? My instincts tell me no, but I'd love to hear some real life experience answers (since my doctor seemed like she'd never treated a pregnant woman before). TIA!

Found this on google
https://www.medicinesinpregnancy.org/medicine--pregnancy/trazodone/

fishsticks-n-custard

The infant risk hotline is also an amazing resource: https://www.infantrisk.com/

JennyColada

Would you be open to finding another psych? I know that when you create a good relationship it's difficult to change, as there is so much work that goes into finding someone that is good for you. But I'd just think that if you're going to be TTC, and thus dealing with all the stress and anxiety that comes with that, with pregnancy, and with motherhood; that you may want someone well versed in how to handle that and how to best support you?

becausescience

I second what @JennyColada says. Find a psych that had experience with TTC and pregnancy or an OB with psych knowledge. 

fishsticks-n-custard

@JennyColada has a good point. You could try searching for a reproductive psychiatrist in your area.

petethecat

Did your psych at least give you safe tapering instructions? Please do not "come up with a plan of your own" regarding that many psych meds. You need the help of a qualified medical professional- not google and not a bunch of internet strangers. Your mental and physical health, and possibly the health of your future child, is way to important to make arbitrary or half informed decisions about. If your phych is not answering your questions, it is up to you to advocate for yourself and to get complete and qualified answers from another professional. Searching for a reproductive psychiatrist in your area is an excellent idea. 

izza2

Who actually prescribed you the medication? Whomever prescribed it should know the possible risks associated with its use and help you determine the need to wean or stop prior to TTC (in conjunction with your psychiatrist, if they weren't the one to prescribe it).
If your psychiatrist prescribed it, I'm sorry, but even if you have a good relationship you should consider a different one. If they're willing to prescribe a medication and can't figure out the pregnancy class and help figure out whether the benefits outweigh the risks for you, they shouldn't be prescribing medication.

Trazodone is a class C drug, meaning there's not enough information to entirely indicate its safety in pregnancy. It should be taken if the benefits outweigh the potential risks.
Sertraline is a class C drug, meaning there's not enough information to entirely indicate its safety in pregnancy. It should be taken if the benefits outweigh the potential risks.
Klonopine is a class D drug, meaning there are known adverse reactions to a fetus from taking the drug during pregnancy.


This is something that you should be able to discuss with your healthcare professionals to decide whether you should continue to take the medications or not. No one here can tell you whether the benefits outweigh the risks for you. Only your health care professionals can decide that, in a conversation with you, and in conjunction with your therapist.

ashh2018

Hi, sorry for ghosting and thanks for the responses. 

Yes, when I said "come up with a system on my own", I meant that we talked about lowering my dosage slowly, but she gave all sorts of "I don't know, however long, at least a couple weeks". I said that I would lower the dosage for four weeks and then check back with her, and then cut in half again. I'm not just turning to the internet for help, don't worry Also, I don't have much of a relationship with this doctor - I started seeing her when I moved here and she was helpful enough (only needed medication monitoring) until today when she proved inxperiencd on this topic. I know that both trazodone and sertraline are class C and that's why I'm going to stay on the low dose of sertraline, but I'm going to slowly taper off the trazodone. 

I wanted to know if anyone here takes trazodone, or had taken it through pregnancy. Finding a regular therapist is my next step. Thank you for the helpful links!

lulu1180

@ah1982 For experience taking any prescription drugs during pregnancy, you would probably have better luck posting on one of the trimester boards as most of the women here are still trying for their first and thus don't have the experience you're looking for.

lulu1180

ah1982 said:

Hi, sorry for ghosting and thanks for the responses. 

Yes, when I said "come up with a system on my own", I meant that we talked about lowering my dosage slowly, but she gave all sorts of "I don't know, however long, at least a couple weeks". I said that I would lower the dosage for four weeks and then check back with her, and then cut in half again. I'm not just turning to the internet for help, don't worry Also, I don't have much of a relationship with this doctor - I started seeing her when I moved here and she was helpful enough (only needed medication monitoring) until today when she proved inxperiencd on this topic. I know that both trazodone and sertraline are class C and that's why I'm going to stay on the low dose of sertraline, but I'm going to slowly taper off the trazodone. 

I wanted to know if anyone here takes trazodone, or had taken it through pregnancy. Finding a regular therapist is my next step. Thank you for the helpful links!

izza2

@ah1982 - Do you have a primary care provider?
OBGYNs are great for your reproductive system, and your therapist is great for your mental state, but you should have a PCP to bring it all together and cover the rest. Including your prescription medications and helping you make an informed decision regarding your medications.

It's great that you're being an advocate for yourself, and I fully commend that. But, you shouldn't be deciding how to change your medication on your own, without a medical professional actually giving you information and helping you come to the decision.

For instance: when tapering off medications that affect your nervous system, it's usually suggested to cut about 10% of the medication every 4 weeks until you either get to a lower maintenance dose, or are off the medication. That's a suggestion, meaning that your doctor may feel you should cut less, or may feel that you are able to cut out more without it shocking your system as much. It depends on how long you've been on the medication, and what the dose is.


ah1982 said:

Yes, when I said "come up with a system on my own", I meant that we talked about lowering my dosage slowly, but she gave all sorts of "I don't know, however long, at least a couple weeks". I said that I would lower the dosage for four weeks and then check back with her, and then cut in half again. I'm not just turning to the internet for help, don't worry  

ashh2018

Yes, I don't have a pcp yet (new to the area) but I am finding one today. I was just a little annoyed with the psychiatrist, since she didn't seem knowledgeable on the medication she prescribed! She suggested the half dose based on my dosage history. Thanks for the advice!

petethecat

@ah1982 I understand the annoyance. I really hope that you are able to find another provider (PCP, new psyc, or other) to bridge the gaps in your care. I have personal experience weaning off of psych meds and know that it can be tough. I hope that your journey doing so is a safe and easy one. Good luck with everything.