Clueless shrink on meds and bf'ing...Help!

[gabysmom617]

After much hardship, I went to the psychiatrist today.

They are suspecting depression and Adult Attention Deficit Disorder as my diagnosis.

They wanted to start me off on either Prozac (because of social anxiety issues) or either Wellbutrin.

But when they found out I was still nursing my 6 month old, they pumped the brakes so hard, I almost heard skidding tires and smelled brake dust! :

They said they needed to talk to another doc (my OB) to find out what I can take for my conditions.

But I just moved, and the midwife I delivered with is far away, like 200 miles...(on second thought, I guess they COULD talk to her over the phone, for she is VERY probreastfeeding, and very familiar with meds I can take...) AND I don't really trust my current local gynecologist to be supportive in offering my shrink info as to what meds I can take while breastfeeding.

Can some one help me figure out what to do?

[boobybunny]

go buy Dr Hales book and slam it on your Doc's desk.

[gabysmom617]

Dr. Hales book?

What's that? What's the title? Do I find it in my local Barnes and Noble?


I wonder if they will take the advice of a book and prescribe meds based on that, or will they just have to speak directly with another doctor?

[jeanine123]

Medications and Mother's Milk. Dr. Thomas Hale is professor of pediatrics at Texas Tech University and a formost authority and drug interaction and lactation. He also has a forum where medical professionals can go and ask questions but it's read only right now as he's working on a new release of his book. If you want the link to the forum PM me.

FWIW according to my 2004 edition Prozac is a L2 in older infants (which I think your babe would be considered such) SAFER:
Drug which has been studied in a limited number of breastfeeding women without an increase in adverse effects in the infant; And/or, the evidence of a demonstrated risk which is likely to follow use of this medication in a breastfeeding woman is remote.

Ped concerns is severe colic, fussiness and crying in one case reported.

Wellbutrin is an L3 which is MODERATELY SAFE:
There are no controlled studies in breastfeeding women, however the risk of untoward effects to a breastfed infant is possible; or, controlled studies show only minimal non-threatening adverse effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant.

Ped concerns, none reported in one study but infant was only breastfed twice a day. Observe for reduction in milk production.

Also, here's a link to kellymom on PPD and common meds prescribed for it.

http://www.kellymom.com/health/meds/...hale10-02.html

It sucks when docs want to take the easy/familiar way out instead of doing some legwork and working with their patients like they're supposed to.

[jeanine123]

Sorry, double post

[Finch]

Tell them to contact this physician at Duke:

http://www.dukehealth.org/physicians...t=Diana%20Dell

She was an OB/GYN before she changed to psych (repetitive motion injury), and specializes in psych care of women. I got the blessing from her to take effexor during pregnancy and bf, and to eventually switch to prozac. My docs were hesitant until she told them to chill.

Seriously. Give them her contact info. She is very well-known.

[gabysmom617]

Really? I can just give them the phone # listed on the website and have them call her?
I don't need to call there first and ask if it's ok for them to call , or anything?

I hate how they just pretty much left me to my own devices! I dont' know about this medical stuff! :

[Finch]

Originally Posted by gabysmom617

Really? I can just give them the phone # listed on the website and have them call her?
I don't need to call there first and ask if it's ok for them to call , or anything?

I hate how they just pretty much left me to my own devices! I dont' know about this medical stuff! :

Not doctor to doctor. Physicians can just call one another, no problem. If YOU were to just pick up the phone and call her, well now that's different...LOL. But she is an excellent resource.

[gabysmom617]

But won't my psychiatrist give them my name and stuff, and won't that duke medical doctor person know that I have never been a patient there? And will that matter to them?

[Ruthla]

There's no reason your psychiatrist can't call your former midwife, even if she is in another town.

[Finch]

Originally Posted by gabysmom617

But won't my psychiatrist give them my name and stuff, and won't that duke medical doctor person know that I have never been a patient there? And will that matter to them?

I don't know, and no it doesn't matter if you've never been a patient, if it's just doctor to doctor getting advice. You're not getting a consult, you're having your doc call another doc who's an expert to get her opinion.

[LeosMama]

It's a normal part of professional scientific discourse for one doctor to call another to discuss something about which one or the other has more or different knowledge. It is, in fact, considered irresponsible and arrogant for a doctor to refuse to consult with another member of his profession who is generally considered to be an authority on the subject matter in question. Doctors consider themselves scientists and encourage communication between each other, even or especially strangers, in order to advance the knowledge of all and to better the treatment of patients.

So while this may seem strange to you, it does not seem strange to the doctors, neither yours nor the unknown woman at Duke.

[gabysmom617]

Ok, well thank you for all the tips! I will be giving my psychiatrist a call first thing in the morning.

[sapphire_chan]

Social anxiety and depression are both symptoms of ADD. You will probably experience relief from all 3 problems by taking medication to help the ADD. Many people with ADD take a combinatio of Strattera and Adderall with the primary side effect being a loss of appetite. Unfortunately, I do not know if either drug is counterindicated while breastfeeding.
Anyway, I'd find out from your psychologist what the plan is for trying the medications. How long will you take something before the dose is adjusted, what if it seems to work at first and then doesn't work, how do the possible medications interact with each other. One major problem in the treatment of ADD is that even people with experienced doctors end up on way too many meds with all the accompanying side effects, because there's an attempt to fix each symptom separately rather than finding the underlying cause.

The other major problem, of course, is that ADD can come from multiple causes, so a drug that works with one variant does nothing for another variant.

Sorry to be scary about this, my mother has been going through the process of figuring out which meds make her feel the way she wants to feel. (Not quite the same as "normal", more "not annoyed with the entire universe".)