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Women on antidepressants: What do you do?
I take an antidepressant, nortriptyline, for my chronic migraines and anxiety. It works great and I feel great while on it. But with the idea of wanting to conceive in the future, am I supposed to taper off and just deal with the chronic migraines and anxiety for 9 months? I am going to be a wreck without my meds, I just know it. Having a migraine nearly 5 days of the week is not something I look forward to. And the anxiety....I'll never want to leave the house.
I've tried going off in the past to see how I'd manage and it was a nightmare. And it scares me to even think about starting a family.
Any advice or tips?
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Re: Women on antidepressants: What do you do?
Most drug references list the medication you're on as a pregnancy class D, which means that it is proven to be harmful to the fetus, apparently causing limb length abnormalities. So regardless of what it does for you, it should not be used during pregnancy. I also get migraines and had to stop my preventative drug during TTC. According to my midwife there are NO preventative drugs for migraines that are safe to use during pregnancy, although SOME of the treatment drugs are (not the triptan drugs).
You should talk to your doctor about switching your medication. There are other medications that are pregnancy class B and C anti-depressants that will help with your anxiety. I am on an anti-depressant and am now almost 5 weeks pregnant.
You should have a plan in place on how you plan to deal with your migraines before you get pregnant. I, also, had severe migraines most days of the week before I started taking medication (Topomax). When I talked to my neurologist, he told me 2 things:
1. For most women, migraines get worse during pregnancy.
2. Most women tend to forget how bad their migraines were before they went on a medication like topomax and quit having them.
We are TTC and I am not going off topomax, even though it is listed as a category D (I have tried a variety of other medications in other classes and no others work to control my migraines). It is an epilepsy medication, so we are approaching it like an epilepsy case: I take a prescription dose of folic acid (very high), as the folic acid at high rates forms something of a barrier and helps prevent the medication from crossing the placenta.
This is what works for me and my family - I remember just how bad it was to have migraines every 2 to 3 days. I remember the pain, I remember how un-functional I became. If the migraines truly became worse, I would be bedridden during a pregnancy - I would not be able to work, leave the house, clean, turn the light on, or sit up.
I am telling you this because it sounds like your migraines were similar to mine and you really should discuss this with your neurologist. A specialist should be telling you about your choices and what works best for people with your condition. He or she may be able to offer you treatment conditions other than going 'cold turkey'. Don't let people try to push you to one choice or another because of what they think is best for your family.
I'm on a low dose of Prozac and have been for over 10 years (not Prozac for all of it, but a variety of anti-depressants until I found one that worked well for me). This is something I'm worried about too because I have a really hard time without it. (It's like PMS times eleventy billion.)
FWIW, my sister suffered has gotten migraines since childhood, had to stop her preventative during pregnancy, and didn't have a single headache the entire time. Something to do with the change in hormones. She said she wanted to be pregnant forever.