Anti-Depressants

shellbell813 · January 2014

A bit of background... I had been on Prozac (40mg) for about 5 years before quitting (cold turkey... long story) about a year ago. I stopped because I knew the bad effects it could have on a baby in pregnancy. I was actually doing fine until we got pregnant. Now I've been struggling... pretty badly most recently.

I had talked with my doctor a bit at our last appointment. We have another (a/s) in 2 weeks. My doctor recommended that I get back on the medicine, but specifically said Zoloft. She said that she especially recommends it before the baby is born to avoid intense post-partum depression. I fully trust her and have done some personal research and Zoloft appears to be fairly safe (not a lot of bad evidence out there...).

My issue is that I know that I don't respond well to Zoloft, or I didn't when they were first trying to find the right medication for me. Zoloft didn't really work and had some side-effects that I was uncomfortable with. I've looked into Prozac and it appears to be the number 2 choice out there, but there are specific links to Prozac and heart problems. I feel like I would only feel right to risk taking the drugs if I knew they would work, but I also sincerely don't want to endanger the baby.

I plan to have a much more thorough discussion with my doctor before doing anything, but I was wondering if any of you ladies had any experience. I've got a crazy internal battle going on because I hate feeling like I can't just control my own body/mind in order to avoid this altogether.

ElTrain5 · January 2014

I know what you mean about not wanting to bother with the medication when you know it's not really going to have the needed effect (and have negative side effects to boot). Here's my suggestion, I would look very closely into the studies that have been done on Prozac, and specifically focus on any information out there regarding when the drug is taken during the pregnancy. The reason is, there are a lot of drugs that are not recommended during first tri due to heart related defects, but are fine during second and third tri. you can try and ask your doctor...but unless they've read the actual studies, It's doubtful they know that specific of a piece of information. But you never know. You could also pose the question to a psychiatrist who specialized in pregnancy, they might be better up to speed on all of the details of the latest research.

TheMrs820 · January 2014

I agree with ElTrain5. Good luck to you on this

MrsP419 · January 2014

This is my second pregnancy on Zoloft and that works for me. With that said, I feel like I what I have read about Zoloft and pregnancy goes pretty hand and hand with Prozac. They seem to be quite similar. You could always give Zoloft a shot and see if the fact that you have additional pregnancy hormones going on make your response different this time. But if you decided to skip that and go to Prozac, I really don't think it would be that big of a difference.

I totally understand the internal battle and the guilt. I wish that I could do pregnancy without meds, but right now, I can't. I compare it to my husband being on insulin; it is something I need to compensate for a hormonal issue my body has. The reality is that the birth defects and negative effects of those common antidepressants are SO much more over-publicized than they should be. Most of the doctors and midwives I have talked to have had no concern at all over putting me on antidepressants. They say the risks that untreated depression has on pregnancy can much worse than the risks that antidepressants have. I think a lot of the scares that we read about are due to lawsuits. The risks exist, but are not common.

sjn00 · January 2014

I was on 80mg of prozac, abilify, and Xanax before I got pregnant.
Now I am on 20mg prozac that I take every other day until I need a stronger dose and then will take it every day. I am being monitored more closely to keep an eye on the babys heart. I started it at week 18 day 5.

So far it has helped me and babys heart is doing fine.

Puka99 · January 2014

I agree with what pp have said. I had to go back on something-the anxiety was getting to me and making me more miserable. If you know Zoloft isn't going to work then I'd try the prozac. I am of the thought that if it's more harmful to be without than on, to do it. For me, it's worth it because otherwise i have suicidal thoughts and get more depressed and that's not good for anyone. Hugs.

chloekallisti · January 2014

I've been on 100mg of Zoloft prior to and throughout this pregnancy. All my Dr's (MFM etc) have echoed what pp's have said. There is far less risk of negative effects on the baby if your medicated vs if your depressed/anxious. That being said, I definitely get your hesitation if you've already tried it and it didn't go well. I don't know whether or not you'd have a different experience now that you're pregnant but considering it takes several weeks to achieve measured therapeutic results (before it "kicks in") I'd probably talk to the Dr again and see if you can go the Prozac route since you already know it works for you. You don't want to spend the next 6-8 weeks hoping the Zoloft will work for you this time around... Especially if it doesn't and then you have to switch to something else and wait for that to kick in. Sorry for the super long response... Hope you feel better soon

jewels1199 · January 2014

I was also on high doses of anxiety medication before pregnancy and I now take 20mg of Cipralex ( starting at 10mg then going up by 5mg at a time )

My first pregnancy I went medication free and had a terrible time with my anxiety and depression

I feel like my anxiety had a huge impact on DS as a newborn ( colic, very angry baby, nervous ect... )

My Dr's did a lot of research before I got pregnant this time and I even see a Reproductive Mental Health specialist to monitor my health in addition to my OB and Psych. I feel SOOOOO much better this time around, but, I still worry that this make the right decision for the baby. All in all I have to remember that all the health professionals are looking out for both baby and my own health. They wouldnt have me take something where the risks outweighed the benefits.
PM me if you wanna chat about it !!

shellbell813 · January 2014

Thank you for the responses. It's helpful to know other people are out there experiencing it too and have had problem free pregnancies with the medicines. I'll definitely be doing a little more thorough research before my appointment.

Gigi8212 · January 2014

I was on a daily dose of 60mg citalopram (celexa) during my first tri with dd. I weaned down to 20 mg in third tri and kept on that dose the year I was BFing her. I went off it a month prior to my BFP with this pregnancy because my anxiety is so low.

For both this pregnancy and my dd I have also been taking .5 mg of Xanax as needed for anxiety. Usually about 2-4 times per week.

Just be really honest with your OB about your concerns. I am sure you will come up with a solution that works for you and is safe for baby.

MrsCase1 · January 2014

Most people change medicines on average 9 times before finding the perfect fit. At least, that is what i read about six months ago. Pregnancy is a whole other ball game chemically and hormone-wise so it just may be that zoloft works this time. i'm just saying to maybe give it a shot, it might take the edge off and then you can go back on the prozac after you deliver.

MrsCase1 · January 2014

Gigi8212 said:

I was on a daily dose of 60mg citalopram (celexa) during my first tri with dd. I weaned down to 20 mg in third tri and kept on that dose the year I was BFing her. I went off it a month prior to my BFP with this pregnancy because my anxiety is so low. For both this pregnancy and my dd I have also been taking .5 mg of Xanax as needed for anxiety. Usually about 2-4 times per week. Just be really honest with your OB about your concerns. I am sure you will come up with a solution that works for you and is safe for baby.

I LOVED Celexa but it made me SUPER fat. sigh. if it isn't one thing it is another, LOL!

celticbiohazard · January 2014

I'm on 20 mg Prozac, and I did a lot of fretting about this before TTC. This website is great:

https://womensmentalhealth.org/specialty-clinics/psychiatric-disorders-during-pregnancy/

After talking to my psychiatrist, as well as other women who had been on medications while pregnant, I felt a lot better about it. I work in a related field so I actually read the various papers on Prozac in pregnancy, and the effects are very small (when any are found, which they are not always). With all observations, there is some probability that what is being observed is a coincidence... the strongest studies stick to effects where that probability is less than 1%, but with these, their cutoff was closer to 5%. That might seem small, but it means that with some of these effects, there's a 1 in 20 chance that they are unrelated to antidepressant use. That's not actually that great, especially since these analyses are all meta-analyses after the fact.

I totally get the guilt, the fear. But the effects of Prozac in pregnancy are very, very dubious. Given the chances we take every single day with everything we ingest, at least you KNOW an antidepressant might be able to help you be a better expectant mom.

The one thing I did do was that I switched from being on two medications to one. There are lots of studies with one med... very few with two. So I switched to just one and luckily that is working well enough for me for now.

You're not alone.

.

hscoggins · January 2014

These posts are very helpful and reassuring. So many people suffer from depression/anxiety and we all know how pregnancy can exacerbate the symptoms.

I was afraid to bring it up with my OB for mostly irrational reasons and I beat myself up over the idea that 'I'm not the perfect pregnant woman bc I have anxiety and feel I can't function without medical intervention that could possibly compromise the health of my unborn child.' This idea haunted me for my first trimester until I finally spoke up. Just talking about it brought relief.

I am comfortably on a benzo at the discretion of a perinatal psychiatrist and was very reassured to learn that despite the stigmas and mostly false info about psychotropic drugs being used during pregnancy, some of these drugs are, in fact, safe to use and furthermore, the drug class category system is actually in the process of being discontinued.

GL to everyone and I, too, encourage you to be honest with your OB/physician. The benefits usually outweighs any risks and what helped me seek help was knowing that I could be doing more damage trying to suffer through the symptoms.

celticbiohazard · January 2014

shellbell813 said:

I plan to have a much more thorough discussion with my doctor before doing anything, but I was wondering if any of you ladies had any experience. I've got a crazy internal battle going on because I hate feeling like I can't just control my own body/mind in order to avoid this altogether.

Also just wanted to add... imagine if a diabetic friend said this to you (a pp compared to diabetes and I think that's a very good comparison). You'd shake her and tell her she's nuts, because she has a medical condition! There's a funny attitude that society takes about mental illness... for some reason, it's accepted that someone with diabetes can't fully control their blood sugar, someone with celiac disease can't fully control their metabolic processes, someone with lupus can't control their immune system... yet someone with depression is supposed to be able to control their mind. Sometimes, for some of us, it just doesn't work that way. If you've done everything you can to change your lifestyle, and you're still depressed, there is no shame in seeking more help. There are some conditions that mean that not eating cookies means that you still have diabetes, and doing all the right things every day means you still have depression. I'm sure you're trying really hard, and I know based on how careful you are about your baby that you wouldn't be considering this unless you really needed the help. Right? So don't beat yourself up about it.

Luna C · February 2014

I don't have personal experience with anti-depressants, but I have watched DH struggle for years to find the right combo/dose of meds that helps him without awful side effects, so I can sympathize.

Can you ask your dr. about other medications besides the two listed? If Zoloft doesn't work for you, it doesn't work for you. But there are SO many meds out there, there must be one that is a better fit if Prozac seems too risky.

And don't feel guilty for needing medication. I need asthma meds to breathe and no one would fault me for taking that steroid every day. Needing anti-depressants isn't any different -- denying yourself needed help and suffering isn't doing the baby any good either. Remember, all of your stress hormones impact the baby, so doing what's good for mamma is also good for baby.

Good luck.

LKHoffa · February 2014

It drives me nuts how so much of the public has such a warped view on mental, as opposed to physical, illness. I agree with PPs- it's a disease, just like diabetes or thyroid disease.

I have been affected by mental illness, and I haven't really told many friends. But I think it's really important to be up front with your doctor.

Good luck! I know you will do what is best for you child- what a lucky kid you have already to have a mom like you!

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