Finding an OBGYN Who With Work With Psych Meds

kfclife

This is a bit frustrating to me. I wish someone had told me how difficult it would be to find an OBGYN who is comfortable providing care for women on SNRIs. I am on Cymbalta, and all the research I had done said it wouldn't be an issue. I spoke to my psych doctor before I became pregnant and they said I would need to talk to an OB, but that it wasn't a big deal. I tried calling OBs about this before I became pregnant, and they told me they would discuss it at my first prenatal appointment. However, now that I AM pregnant, they won't book the prenatal appointment, because they aren't comfortable providing care. Now I'm scrambling to find one. Has anyone else dealt with something similar?

Also, if I was wrong to post this here, please let me know and I will delete.

lizarose0716

@kfclife I’m so sorry you are dealing with this! 

I’m planning staying on my antidepressant throughout pregnancy. I’m also a pharmacist, so I could bore you with a bunch of info, but I don’t want to do that, nor do I want to try to replace the judgement of your psych doctor or your OB. But I’ll give you my two cents for what it’s worth. 😊

Cymbalta is a newer medication (new being relative, I know it’s been around for years) so there aren’t as many studies on it, which is why some OBs might be more hesitant to use it. SSRIs (like Zoloft) have much more extensive studies done on that, so it is much more regularly used in pregnancy. I don’t know if switching to an SSRI is an option for you? Your OB may be more comfortable with that. 

Ultimately I decided (after talking with my OB) to stay on my Prozac because I know that without it I would be dealing with a lot of depression/anxiety which wouldn’t be good for a fetus either. 

Dealing with psych issues is common during pregnancy so I’m sorry it sounds like your OBs office is shutting you out!! Hopefully you are able to find someone soon! 

peyts228

@kfclife sorry to hear you're encountering resistance!

I'm on an atypical antidepressant (remeron) that is neither an SSRI nor an SNRI. I was also taking it during my first pregnancy under regular OB care. Since it's also a bit newer and understudied, my regular OB consulted with a maternal fetal medicine specialist just to be sure. My OB office actually partners with an MFM office for all anatomy scans and for patients with high risk conditions. Maybe you can find an OB office with a similar arrangement?

kfclife

@lizarose0716 I can understand some hesitation, I just kind of wish I had known before so I would be more prepared to face this hurdle. Unfortunately I tried several different SSRIs and they were not effective. It's only been with the Cymbalta that I have had success, but it may not hurt to have another conversation with my mental health provider. Thank you 😊

kfclife

@peyts228 I will definitely see if I can find an office like that! I plan to make some more calls tomorrow. I'm glad you were able to find someone in your situation, so it gives me some hope for mine!