SSRIs and pregnancy

[katiedidbug]

I am 4 wks 1 day pregnant. I've been on Zoloft or some other SSRI since I was 11, except for when I pregnant with DS 1 and 2 or post-partum. I was very depressed during DS2's pregnancy, and I don't want to have that again. I want to stay on something. My MW, though, is not comfortable with Zoloft, and is suggesting I try Welbutrin. Right now I'm working on weaning myself off the Zoloft and I have an appt on Wednesday to get a second opinion about Welbutrin. Does anyone have any experience or thoughts? I know many of you might say that I should not be on anything, but I really would like to be on something; I'm a much better mother and spouse when I'm taking an anti-depressant. The other possibility is to not take anything for the first tri, but then pick up again in the second or third tri. Thoughts on any of this?

[anne1140]

Why is your midwife uncomfortable with Zoloft but comfortable with Welbutrin? I've heard that if you have to be on an anti-depressant, Zoloft isn't a bad one to be on.

I am currently on Zoloft due to panic attacks and anxiety. I don't know if I'll be going off of it or not. I'm having conflicting feelings, and I haven't talked to anyone about it yet.

[MamaChef]

Ditto what anne said. Ive always heart Zoloft was the best SSRI to be on during pregnancy and nursing.

Here is a thread you might find helpful
http://www.mothering.com/discussions...d.php?t=266044

[lillymonster]

Originally Posted by MamaChef

Ditto what anne said. Ive always heart Zoloft was the best SSRI to be on during pregnancy and nursing.

Me too. I took zoloft while nursing my daughter for a year. I thought about going on it again during pregnancy, but turns out most was from terrible morning sickness and I feel better now.

[Lauren82]

I was also told by my psychiatrist and midwife that Zoloft is one of the safer SSRI's to be on during pregnancy.

[katiedidbug]

Thanks for the link to the previous discussion. That was helpful to read. I guess her main concern is SSRIs in general, so that's why she's thinking Welbutrin. Welbutrin's not an SSRI, right?

[bananabee]

I've been on Lexapro since mid-2nd trimester, and did some research via google before I went on it. SSRIs are known to cause heart defects in the first tri. When it comes time for us to have the next one, my hope is to wean off for the first tri, and go back on if/when I need to after 15 weeks or so. I have anxiety, but it isn't severe enough to prevent me from going off it temporarily.

[tinynyota]

I started on a low dose of Wellbutrin after the 1st tri, and I don't regret it for a moment. Personally, I do much better on it than on SSRIs.
Most of the concerns about both Wellbutrin and SSRIs are about the potential for heart defects early on, but, until recently, there were very few studies of Wellbutrin in pregnancy, so most docs opted for SSRIs since they are more "known". There have been more recent studies that show Wellbutrin to have no more risks than SSRIs, so I feel very comfortable taking it. If you feel stable enough, you might consider holding off until the 2nd trimester to offset some of the heart defect risks, but even if you don't, my personal opinion is that the benefits outweigh the pretty small risks.

In general, though, I think both Zoloft and Prozac are very well studied and would be good drugs to stay on if they work for you. Do some more research on Zoloft - from what I've heard it's a good option for pregnancy. I wouldn't switch to Wellbutrin (or anything else) if Zoloft is working well for you!!

Good luck, and let us know what you decide to do. It's not an easy choice, but your wellbeing is crucial!

[nova22]

I would be extremely hesitant to switch if Zoloft is working for you. If anything I'd switch to a lower dose at my HCP's recommendation, or I'd stop taking it altogether and try a homeopathic nerve tonic (which is what I use now). I have taken both Zoloft and Prozac and had very different results. Prozac took the edge off of my anxiety but it also gave me horrific nightmares, made me black out periodically (including while I was working or driving), made my hands shake like crazy, and I would randomly have hysterical crying fits (also while working). I took Zoloft a couple years after I had stopped Prozac and didn't have any side effects, except maybe a change in my sleep pattern (nothing that disrupted my life like Prozac did). I have no idea why the two drugs, which are so similar, caused such different side effects, but it actually happened to a friend of mine in reverse - she loved Prozac but Zoloft made her feel much worse. Because I have that experience under my belt I would not switch from one antidepressant to another during pregnancy, even if one is not an SSRI. That's just my two cents, clearly you and your midwife know your history better than I do.

[myk]

i would NOT recommend weaning too quickly or cutting yourself off. i tried weaning too quickly with my first, and it was a complete and utter disaster, i needed a week in a mental health unit.

SSRIs are the safest mood disorder drugs for pregnancy, according to my research. there are a few instances of the baby being crabby or needing just a little extra help breathing (no deaths, just slight delay), but that's extremely rare. for me, the risk of discontinuing it was WAY WORSE than continuing.

i actually had to increase my effexor dose while pregnant, and my daughter had absolutely no ill effects whatsoever. i'm on celexa with this one and baby is healthy so far (i've already had fetal assessments). no way will i go off my meds, i need them to be a good mom and take care of myself.

wellbutrin is NOT an SSRI, and i don't know anything about it in terms of pregnancy. my Davis's Drug Guide for Nurses lists it as pregnancy category B, which is fairly safe. zoloft is the same. DEFINITELY consult a doctor before making any changes, and make changes SLOWLY. you don't need neurotransmitter shortages on top of pregnancy hormones!! trust me.

good luck.

[COgirl19]

I took Zoloft this last pregnancy and had a totally normal pregnancy, birth and baby. I would NOT wean yourself off. I did that with DD1 and it made the post-partum period 100 times harder. I am much better this time around with not stopping it.

[Kellyh_01]

I attended a conference this spring with Dr. Hale and one of his topics was pregnancy/breastfeeding and depression. His recommendation is that if the woman has found what works for her, she should stay on it. The risks of a depressed mother are higher than the risks of SSRI exposure. The studies he referenced showed no difference in children at 4 years of age whether they were exposed to SSRIs or not. If Zoloft has been working for you then don't change it. It is one of the safer ones, and is transferred into breastmilk in the smallest amounts once you're breastfeeding. Prozac is another good choice. Wellbutrin works completely differently and likely won't work as well for you. You've obviously been dealing with depression and medication for a very long time, and you don't sound like someone to me who should be trying to get off their medication, especially during a stressful time like pregnancy. And you have 2 other children that you're mothering. They need a healthy, well-balanced mama so that they can thrive as well. Looking at the whole picture, I don't think you should change a thing. Good luck to you as you weigh this all out.

[Liora]

When I was trying to get pregnant with DD I saw a psychiatrist that specializes in pregnancy and she assured me that the benefits of the SSRI was well worth it while pregnant since women with depression have a much higher rate of PPD. I was on Paxil and she switched me TO zoloft for the pregnancy. I've been on zoloft ever since and I'm still breastfeeding. My DD has never had any effect from it.