Celexa during pregnancy & breastfeeding?

[susla]

I am 31 weeks pregnant and considering starting Celexa due to anxiety and panic attacks which seem to be getting more frequent. Has anyone here taken Celexa during pregnancy and while breastfeeding?

I had a consultation with a psychiatrist who specializes in reproductive psychiatry and she said that Celexa is usually her top choice for pregnancy and it's been very well studied. She mentioned there was less scientific research on breastfeeding than on pregnancy. I have some resources to look at to get more info on the research, but I wondered if anyone out there has personal experience taking this medication...I'd love to hear it.

Thanks in advance!

[UrbanMamma]

I am currently taking Celexa which I started when my babe was about 12 months old and still breastfeeding. We continued to breastfeed until he was about 18 months old. He is 26 months old now. Not the best comparison for your situation, but you asked.

The internal med guy prescribing Celexa was uncomfortable with me breastfeeding... he couldn't understand why I wouldn't just wean. He also didn't think I had PPD but rather regular depression (never mind I hadn't been functional since the babe was 8 months old but that was brushed aside as thyroid). Anyhow, I went home and did the research. I don't have the sites/studies now, but my impressions (this was a year ago and pretty depressed) was that there was no more reason to not take Celexa than any of the other commonly prescribed PPD SSRIs. I think the notion at this point is that Celexa has been around for quite a while; most problems would have surfaced by now. Anyhow, at that point I had night weaned to a bottle, so I just took my meds after I put him to bed. Somehow that seemed logical enough for me to be ok with it?

I have not really researched it for pregnancy (I'd be concerned about dosage right around the birth... do you need to switch SSRIs to have the least amount of withdrawl for your baby?). That said, if I can't get weaned off this summer, I have every intention of trying for a baby on it in the fall. You have to do what you have to do, you know?

Celexa has been great for me. It takes the edge off from the anxiety which then allows me to be able to parent and be the person I want to be. I have a ton more patience and physically feel better without the tension. I have found at 40 mg take away my "drive" to accomplish things. This isn't a horrible thing short term, but I've had to reduce down to 20 in order to feel enough anxiety to get my butt up and moving on things that are not absolutely essential to the moment.

[susla]

Thank you for sharing your experience. It's good to hear that Celexa's been effective for anxiety for you. I have actually taken it before-I took it for about a year 10 years ago and it definitely worked well for me then. I'm just feeling nervous about taking it while pregnant, and during the first months of breastfeeding when the baby isn't on much of a schedule and it would be difficult to time the dosage so it wasn't close to a feeding. But ultimately I think my well-being and my family's well-being are really starting to suffer and I need to do something about it.

According to what the doctor told me, withdrawal symptoms in the newborn are very rare and almost always mild....still worries me, but like you said, sometimes you have to weigh the risks vs the benefits.

[annekh23]

I'm on lexapro, not celexa, but they are pretty much the same, lexapro is one of the two symmetrical molecules found in celexa. Both are L2 for breastfeeding according to Hale and the half life is such that the transition between pregnancy and breastfeeding shouldn't be a problem, it's mainly prozac that is, due to it's long half life.

[UrbanMamma]

You are welcome.

One thing about the newborn withdrawal issue that I have questions (maybe someone has answers) is the extent to which the proportion of dosage passed onto the babe changes from in utero vs exclusively breastfeeding. If breastfeeding passes it onto the baby, then it seems the withdraw effects should, minimally, be less than otherwise? Is there any literature out there regarding this?

One of the hardest parts of deciding how/if to deal with the anxiety driven depression when I had a newborn was differentiating whether I was nervous because there is sufficient risk or if the question of medication is being blown out of proportion because I was overly anxious. Mind you, I work in a profession where I make fairly neutral judgments about scientific literature all day long. Yet, it was hard to take that jump when it was about ME and even harder to admit my anxious intuition was pointing me in a wrong direction.

[Carhootel]

I took celexa throughout my pregnancy but switched to zoloft when ds was born/while breastfeeding. I read some threads here but ultimately went with my midwifes recommendation that zoloft would be better while breastfeeding. I sort of prefer the celexa and might consider going on it again when I'm done breastfeeding.

[bjorker]

I've been on Celexa for a little over a year and a half, and am 19 weeks pregnant. I had the misfortune of having to switch insurance and therefore doctors (since the prior doc was thru an HMO) right when I got pregnant. I had to start all over again with finding a dr to prescribe Celexa for me when my refill ran out (I'm using midwives for the pregnancy that can't prescribe drugs).

I found that I really had to stick up for myself on this one, because most doctors and nurse practitioners know SO LITTLE about SSRIs and pregnancy. When I first went in, the dr had only just looked it up briefly in a book before she came in, and was concerned based on the blurb about pregnancy, breastfeeding, and Celexa. She said it wasn't so much the pregnancy part that worried her, it's Celexa and breastfeeding newborns. She was just going by the classification it gave, not any *real* information on the subject.

I had to go do my own research and bring it back to her. I was able to find Dr Hale's book "Medications and Mother's Milk" at the library, and some articles & studies online, some linked via Kellymom.com. The problem is that there has been so few official studies on various medications and breastfeeding (particularly because bf'ing is not much of a moneymaker for any company to help fund studies), so there's not a whole lot of concrete information. However, all of the anecdotal evidence points towards Celexa being pretty safe during pregnancy and breastfeeding. Dr Hale put it third on his list of preferred SSRIs, behind Zoloft and Paxil (though this was back in 2002). However, Paxil has been more recently discouraged in pregnant mothers (and I personally didn't have the greatest experience with it). Zoloft seems especially hit-or-miss with people, and I personally was scared to try and switch to it.

The bottom line was...
My midwives AND the nervous dr I saw did all agree that it's better to be on something if you need it, rather than subject your baby and yourself to a flailing anxious or depressed mother. And that's really what it comes down to. Nothing that I read made me think that taking the chance to go off of it or even switch was the best thing for me and my baby. That's not to say that they won't have any of the drug in their system, but it's such a negligible amount that it doesn't really seem to concern any professional that actually knows anything on the subject. Lower doses are of course best, so I would definitely recommend to try a low dose for at least a month to see if that does it for you. I'm on 20mg of Celexa, which is the starter dose, and has been the difference between functioning and not functioning for me.

Anyway, that's my experience and my two cents. HTH, and best wishes to you.

[susla]

Thanks for sharing your experiences. I wanted to update to say that I did make the decision to start taking it and have been taking it for almost a week. My doctor is having me go up to 20 mg really gradually, so I started by taking 5 mg for 4 days, now 10, then 15, then 20. So far I haven't had any side effects and although my anxiety is still very much present, it feels just slightly more manageable to me right now. I attribute this more to having made the decision to do something about it than to the medication itself, although who knows.

Anyway, I feel good about the decision-it had gotten to the point where something needed to be done, and in the research I did I just didn't find anything that made me think it would be more of a risk to take the meds than not to. Hopefully I'll continue to feel better and will avoid going through a bad postpartum period...we'll see.

[devon]

After a lot of problems and a previous pregnancy where i didn't treat the perinatal depression which then turned to PPD, I decided eventually to take citalopram (generic celexa) this past pregnancy starting around 32 weeks. The psychiatrist I went to recommended this over zoloft for me and my HB midwife was very comfortable with me taking it as well. I started at 5mg, then up to 10mg, then up to 20mg by the end of the pregnancy. It helped a lot then, as well as PP. I was able to go down to 10mg about 3 months after birth and just recently (10 months after birth) went back up to 20mg during a very stressful/anxiety filled time.

Both the psy. and my HB midwife who is also a LC were very comfortable with me taking it while pregnant and BF.

I think it is a wise decision to do and it sounds like you are happy withyour choice!

[Mommy2Austin]

I started Citalopram (generic Celexa) about a month before I got pregnant. I was also prescribed Xanax as a breakthrough medicine until the Citalopram was in my system. I didn't have to take the Xanax for long, but I started at 10 mg and it was too strong to begin with. The dr. had me cut the pills in half and go from there. I took the 5mg until mid-pregnancy when I started getting anxiety attacks again (though never as bad as before.) I started taking 10 mg at that point and have been on it since. Baby is 2 weeks old and happily breastfeeding with no signs of any issue.

The risk/issue of me not being on the medication, for me, was much higher than the small risk/issue of the baby having problems.

[cushy]

Originally Posted by UrbanMamma

One of the hardest parts of deciding how/if to deal with the anxiety driven depression when I had a newborn was differentiating whether I was nervous because there is sufficient risk or if the question of medication is being blown out of proportion because I was overly anxious.

This is a very good point. I was on Zoloft and Serzone about 11 years ago and they were very helpful. I now have a 4 month old and am EBFing and I'm concerned about taking citalopram because of how it will affect him. I was prescribed it by a GP in my doctor's office, but I'd never met him before and was wary of his opinion. I've since had a super stressful week (my 2 youngest had frighteningly bad asthma attacks on the same day, then the older two got a really bad stomach virus). This prompted me having to tell my husband to come home early and my crying on and off for 2 days. Now I don't know if my anxiety is justified because of their illnesses, if it's PPD, or if the difference matters. I left a message for 2 therapists because I don't want to take the citalopram, at least not without talking to someone first, but I don't even know if my concerns about taking it are rational. And no one's calling me back so I have no one to talk to! Sorry if I'm hijacking this thread, I'm just very interested in this too.

[bjorker]

Originally Posted by cushy

This is a very good point. I was on Zoloft and Serzone about 11 years ago and they were very helpful. I now have a 4 month old and am EBFing and I'm concerned about taking citalopram because of how it will affect him.

The possible effects on a 4 mo old are much, much less of a worry than effects on a newborn.

http://kellymom.com/health/meds/anti...tml#Highlights

In all studies thus far, any negative effects of medication usually occur in the first 30-60 days postpartum, so breastfeeding beyond that and taking medication is usually fine.

[bizzibee1]

I have been taking Celexa for just over a year. I started when I was BFing DS and I am now 28 weeks pg. I am only on 10 mg for mild Anxiety. When I asked my GP about taking it during PG whe said i was much benn on it then off it and its not a problem. When I transfered to my OB she said the same thing. Good Luck!

[MPsSweetie]

So, I'm guessing that even though the dr (who I will never go back to) freaked out about me still nursing a 3yo in the first place, was ill informed about citalopram and breastfeeding? Please say I'm reading this right. I've got the meds right in front of me, and this anxiety is about to kill me. He only nurses once or twice a day!!

[Mommy2Austin]

Originally Posted by MPsSweetie

So, I'm guessing that even though the dr (who I will never go back to) freaked out about me still nursing a 3yo in the first place, was ill informed about citalopram and breastfeeding? Please say I'm reading this right. I've got the meds right in front of me, and this anxiety is about to kill me. He only nurse once or twice a day!!

I took it while pregnant and breastfeeding with no ill effects. Both my baby's are perfectly perfect

[mediumcrunch]

I go off my ssri when pregnant. Stick turns blue I stop taking them. I take all kinds of drugs for my hyperemesis but I just can't bring myself to take the Lexapro-I can't give you a reason or a study, I just can't-I think it would actually increase my anxiety.
Now I took Lexpro very successfully twice postpartum but both times waited until I was miserable and once non-functional. This time? I'm getting a scrip at my 6 week visit...at the latest.
My psychiatrist, two pediatricians, a GP and my rheumatologist have NO problem with me nursing and taking Lexapro. Zoloft did NOTHING for me but dry out my mouth.