Pregnancy and Antidepressants

MsEmma1980

Hi All - I'm not actually in my 3rd trimester, or even pregnant, so I hope you don't mind me infringing upon your board!

I'm currently on antidepressants, and my H and I thought we'd start trying to get pregnant this summer, but now are waiting due to some issues I had this past spring.  I really couldn't function at this point in time without the antidepressants.

Point being, we're thinking we'll wait another year, but I'm concerned about coming off the antidepressants, but that would be my preference while pregnant.  The labels seem to say that you shouldn't be on them during your third trimester, but wouldn't it make sense that it would be dangerous the first 2 trimesters as well?

Worried about safely having a family ... and not losing my mind for 9 months to do it... 

misspunky

I was on antidepressants for a long time and got weaned off of them. I'm sure you're aware, but you need to have a doctor supervising you until you're off of them and doing OK. Luckily I was off of them by the time I got pregnant, since it was unexpected. For the most part I'm completely fine, but alot of things have changed to take stress off me. My doc always warned me of the risks of taking them during pregnancy and never specified which trimester, but implied that it's safer to be off completely.

Talk to your doc about your concerns, since he/she knows your history and would be able to help you do it safely.

punkrockabye

There are certain medications that are recommended during pregnancy if a mom would benefit from antidepressants, so it's definitely a good idea to have a talk with your doctor about your options! It's certainly safe to do with the right choices and it many cases, being on medication is much better for the baby than having a mom who needs medication but isn't on any. I believe one reason why it is suggested that some kinds be avoided late in pregnancy is because of withdrawal; for example, if you stopped taking the medication cold turkey, you'd go could through some nasty withdrawal, including "brain zaps" (google it, it's horrible and miserable). Well, if you're on certain kinds of meds up until you give birth, the baby can experience some of those nasty withdrawal symptoms, just as if they were taking it themselves and suddenly stopped.

As for my personal story, I had been on citalopram (generic Celexa) for quite a while. I'm 26 and I've had issues with anxiety and depression since I was 5-6 years old. I was doing just fine on citalopram when I got pregnant, and the midwife I was seeing (knowing I'd switch to a high risk OB at 7-8 weeks) gave me two options: switch to a safer medication, or wean myself off of it and see how I do. I'm currently unemployed but I am a licensed social worker with a psychology background, so I felt confident in my own abilities to monitor myself and pay attention to my body. I opted to see how I did without the medication.

I assumed I'd be calling a while later to be put on something else but that day just never came. For some reason, with pregnancy, I feel better emotionally than I ever have. Nobody can really explain it, so I just attribute it to luck and the incredible amount of hormonal shifts that took place. The past several months have been really stressful with us being put in a really, really awful financial situation, so while I have been worrying about that, it hasn't been destroying me; before pregnancy even with the medication I would have been a wreck.

Some women are the exact opposite while pregnant. A family member with no history of depression was an absolute mess during her last pregnancy, so much so that she had to go on medication and keep in contact with a doctor every day to monitor her safety. I feel like I got really lucky with this, so in no way am I saying "just stop taking it, you'll feel fine." Of course going off medication and monitoring yourself is one option but there are others out there--I wouldn't have done it had I not been doing well for several months to begin with. Also, given my history, I'm going to be watching myself really closely for postpartum issues, and DH is aware of it as well and he's not afraid to give me any wake up calls if he thinks I need help.

ks3pink

Zoloft is safe during pregnancy.  Idk what med you are on but talk to your doctor and see if you can switch to something like that that would be considered safe.  I have taken my full dosage of Zoloft the entire pregnancy and everything appears to be fine with both of my babies.  GL!

sourapplemartini

I've been on my meds for the duration of the pregnancy. I tried to wean off, made it to 11 weeks and couldn't do it anymore. It was more important to have my mental health and not be a miserable basketcase for 10 months. 

calliope753

Ditto to what all the posters have said. I weaned off my antidepressant before getting pregnant, but when my OB saw me being unstable (anxiety, etc.) during my annual exam before pregnancy, he felt strongly that I should go back ON the medication so that I could be stable while pregnant. He felt that not only was the benefit to me enough to outweigh what he saw as a very small risk but also that the baby would benefit from not having a mother who was having panic attacks. (apparently the stress hormones can reach the baby.) So- I've been on lexapro ever since. I checked with the OB recently about the need to wean before birth, and she (this is one of the other docs in the practice) said that the instance of withdrawal is fairly small as well. Both have seen lots of patients and babies do well while on meds. This was the decision that was right for me- I would definitely talk to any and all of your doctors.

Good luck!
Callie

chazzgirl

This is my 2nd pregnancy, and I have taken 20mg of prozac for both.  I switched to it from celexa just before trying for baby #1.  DS1 is a perfectly happy healthy little boy and so far all signs point to DS2 being the same. 

I feel this is a very personal choice.  I weighed the risks, but decided with my fam doc /OB that a happy and anxiety free Mommy is worth the minor risks with such a small dose.

I have had anxiety my whole life but the summer of 2008 suffered a crippling episode of anxiety that landed me in the hospital.  I did a year of therapy and that combined with the meds has changed my life!!!!!

 Good luck to you!

MississippiCatfish

This is my first pregnancy and I have continued to take Zoloft (sertraline) every day.  I am an RN and read through quite a bit of medical literature and felt that in my situation, it was much more beneficial to continue taking the medication than to wean.  I have attempted to wean several times over the past ten years, all unsuccessfully.  I have been able to reduce my dose to 12.5, which is quite low -about half of the typical starting dose. However, when I stop the medication entirely, my thoughts become clouded and I become overwhelmed easily and have difficulty with decision-making. Even though it's mild, my depression and anxiety has a significant impact on my relationships (I tend to withdraw), and I know that it would be detrimental to my marriage, which is not a road I wanted to go down during pregnancy. 

Everyone needs to do their own research and come to an educated decision that they are comfortable with in their own situation.  Good luck TTC!

judahsmommy1

I was talking with my doctor about this. She said that the hormones tend to affect people with depression in two ways: it either makes it better or does nothing. With my first pregnancy, me depression improved significantly during pregnancy. With my current pregnancy I've needed an antidepressant.

MainelyFoolish

This is something to discuss with your doctor. For a lot of women, it's better to stay on the meds throughout pregnancy. The risk of side effects for the baby with staying on some meds in the third trimester is very small.

White0rchid

I started Zoloft after DD1 was born, and I weaned off by 20 weeks pg with DD2 and I was off at 26 weeks with DD3. My OB really wanted me to see if I could make it without it. It's been rough at times, but I feel good now. The issue with taking it in the 3rd tri is some chance of the baby having withdrawal, but it also can cause issues with the baby breathing after birth. That's why my OB wanted me off if I could manage without it. There are obviously women who need it to the point that they would need to stay on it. I would suggest making an appointment ahead of TTC and talking with your OB about it.

mom2skh

I had a history of depression/anxiety on and off for years and was on Lexapro.  I weaned myself off before getting pregnant with DD, and was able to not need it during that pregnancy. However, after DD was born I got pretty bad PPD and needed to restart it. I stayed on Lexapro for over a year until I was weaned off to get preg with this baby.  I have again felt good, but with a history of PPD my OB and I have discussed that I have a very strong chance of getting it again after this baby is born, so we have decided that at 32 weeks I will restart Lexapro.  There are very few risks with that medication, and the risk of having me be barely functioning with PPD is much worse to the baby than being exposed to the meds. I agree with PPs, schedule an appt with your OB right before you start TTC and discuss it with them to see what is best and what options you have.