Question about meds

[secondtimemom09]

I have a question about taking meds. My OB prescribed Prozac for my PDD and I have yet to start taking them. My son is 9 days old and breastfeeding, and I'm just not comfortable with the thought of him "taking" Prozac too. Also, I'm worried about it being addictive. I was wondering about anybody eles experiences with Prozac or any other meds. Did they work? How long were you on them? Was it easy to get off them? Any natural remedies?

[Autumn Breeze]

When I started on meds I called a friend of mine (an IBCLC) who suggested I call Poison Control...They can tell you category of the drug, and the half life, so about how much you will have in your milk. The women I spoke with at P.C. said they get these kinds of calls all the time, and they have a copy of Hale's.

If you aren't comfortable with what you OB suggested and prescribed, get a referal to a psychiatrist and see if they agree or want to change your medications. I personally believe that OB's shouldn't be prescribing psychiatric drugs, but that isn't the topic.

You aren't alone! Come back and talk to us as much as you want.

[secondtimemom09]

If you don't mind me asking, what medication were you on? Did it work for you and was it easy to eventually stop taking?

[Autumn Breeze]

I took Lexapro for depression - which I took for about 6 months before weaning off. And I weaned very slowly, but it was ok, just some dizziness. I'm also still taking Ativan (anti anxiety) as needed, and Lamictal every day (bipolar).

[Limabean1975]

You can also call Motherrisk - they keep up to date with the very latest study results. They are fantastic. http://www.motherisk.org/women/index.jsp - call the (416) number - you will pay long distance but that's it (from the States dial 1-416 etc)

[georgia]

You might also consider reading this Mothering article and checking out Dr. Hale's information, too.

The most popular family of antidepressants is the serotonin reuptake inhibitors (SSRIs), including fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and others. Prozac, the best-selling of this group, is presently the subject of some concern. It is metabolized to an active, long half-life metabolite called norfluoxetine, which has a long 360-hour half-life. This metabolite has been found in high levels in the plasma of several breastfed infants and has been correlated with a number of untoward effects such as colic, lengthy crying, vomiting, decreased sleep, watery stools, and coma. Because Prozac now has FDA clearance for use in pregnancy, infants of mothers taking it will be born with high levels of the drug in their plasma. In these cases, it is possible that the small amount transferred in breastmilk will continue to build to toxic levels. Fluoxetine should no longer be viewed as a preferred product for breastfeeding mothers with newborns, whose infants may not be able to eliminate the drug well. In older infants it is probably much safer.

The use of Zoloft, on the other hand, has been reported in more than 30 breastfed infants, and appears to transfer poorly to the infant and with no reported effects.18,19 Thus far plasma levels in most infants have been close to or below the limit of detection, with no reports of untoward effects in the infant. At this time, Zoloft is probably the SSRI of choice for nursing mothers. Several reports of Paxil use suggest that its levels in breastmilk are exceedingly low, and the amount transferred to the infant would be minimal.

I would suggest discussing the different options with your healthcare provider.

Here is a popular thread about natural remedies, too: http://www.mothering.com/discussions...d.php?t=195601

Best wishes

[Autumn Breeze]

Great resource!

IIRC The Lexapro had a 25 hour half life and the Lamictal has a 29 hour. It's been about 2 years since I made that phone call.

[estercita]

Of the available ADs, I believe Prozac is considered the least safe for breastfeeding. See for example, this summary from Kellymom: www.kellymom.com/health/meds/antide.... Zoloft is widely considered the safest choice.

Here's the summary on Prozac from the LactMed database (toxnet.nlm.nih.gov/cgi-bin/sis/html...). This is a fantastic database that summarizes all of the research on any drug. You can also look up info on Dr. Hale's website: neonatal.ttuhsc.edu/discus/messages...

Prozac

"Summary of Use during Lactation:
The average amount of drug in breastmilk is higher with fluoxetine than with most other SSRIs and the active metabolite, norfluoxetine, is detectable in the serum of most breastfed infants during the first 2 months postpartum and a few thereafter. Adverse effects such as colic, fussiness, and drowsiness have been reported in some breastfed infants. Decreased infant weight gain was found in one study, but not in others. No adverse effects on development have been found in a few infants followed for up to a year.

[mamatolevi]

Originally Posted by secondtimemom09

I have a question about taking meds. My OB prescribed Prozac for my PDD and I have yet to start taking them. My son is 9 days old and breastfeeding, and I'm just not comfortable with the thought of him "taking" Prozac too. Also, I'm worried about it being addictive. I was wondering about anybody eles experiences with Prozac or any other meds. Did they work? How long were you on them? Was it easy to get off them? Any natural remedies?

Prozac is not known to be addictive that I'm aware of. It worked for me for a while, and then we had to up the dose. I found, and my dr found in most of his patients, that the generic prozac needed to be upped more frequently and seemed to lose effectiveness over time whereas the brand did not. This was not a brand bias on his part; he was fine with generics in general.

Stopping was easy. I just stopped - under dr supervision; I wasn't on a very high dose, though. We ended up switching to another med b/c it was not working as well for me as we felt it should have been.

Remember, your baby isn't getting the full dose you're getting. It's a very small amount of the metabolized prozac (norfluoxetine, if I remember my reading correctly) that gets into the milk. Neither of my two kids were affected by it at all and they were regularly checked by my dr as part of the studies on antidepressants and breastfeeding.

Prozac has an advantage for the pill-taking challenged (as in "I forgot to take my meds today") in that is has a long half life. So if you miss a day, you may not immediately feel like crap. That was an issue I had with other meds that had a shorter half life.

given you're only 9 days pp, are your sure it's PPD? it could be baby blues, or just plain old stress and sleep deprivation making you feel unwell. Is there a history of PPD that would cause your dr to make this diagnosis this soon?

[secondtimemom09]

Originally Posted by mamatolevi

given you're only 9 days pp, are your sure it's PPD? it could be baby blues, or just plain old stress and sleep deprivation making you feel unwell. Is there a history of PPD that would cause your dr to make this diagnosis this soon?

I'm beginning to think the same thing. I'm trying fish oil and exercise right now, it seems to be helping. I did have some problems when I had my daughter, it went on for until she was about 6 months, anxiety and the worst was nightmares on a regular biases. I didn't seek treatment then and made it through. I think I'll keep up with the fish oil, eating good, and exercise outdoors and see if I can make it through again. I'm kinda surprised by how fast my doctor wanted to medicate me, I didn't even see him face to face.

[mamatolevi]

Is your dr aware of your history? if so that might be why he was quick to medicate. Pretty irresponsible to dx and rx w/o seeing you either way.

If you're not feeling better ina couple of weeks w/your current regiment, then find a psychiatrist/therapist that knows PPD. Let your husband know how you're feeling so he can keep an eye on things to help make them as low stress as possible for you.

In the meantime if you get scary thoughts, get out of the house and be with people. I remember one bad day in particular where I called DH to come home NOW. Baby was fine, but I was such a complete wreck I couldn't take care of him.

[secondtimemom09]

Right now it's mostly anxiety, having a hard time sleeping when I get a chance, but Ambien has been helping with that. But weird dreams are starting, but then again that could be the Ambien. My husband knows and is helpful, but we are wary of medication. I recently lost someone close, even though the antidepressant wasn't the cause of death, it aggravated their health situation. So, I'm going to keep plugging along for now.

[MCatLvrMom2A&X]

If you do decide to use an antidepressent zoloft is the one of choice for bfing because it is nearly undetectable in your milk. www.kellymom.com has some great resources.