antidepressants? (support only please)- UPDATE #21

[maisiedotes]

I have been depressed since I believe when I was 8 years old (and on antidepressants for the last 7). When I got pregnant I went off everything but I am *really* having a hard time right now and I am thinking about asking my practitioner about getting me on something. I am concerned about the effects on the baby, of course, but I think the effects of the depression would actually be worse. I can't stand being home alone- all I do is cry and feel like I am going crazy. It is bad. I went through a suicidal period after I had my son in 2005 and occasionally those thoughts creep back in but not as serious.

anyway, is anyone else taking anything? I have been struggling with it for a few months now... I don't believe it is pregnancy-related since it has been going on for so long. So, if anyone is taking anything, what is it and have you done any research on it? Thanks for any help.

[Tofu the Geek]

Not in your DDD, but you could reference this book for after the babe is born and you are breastfeeding http://www.amazon.com/Medications-Mo.../dp/096362198X

[myjulybabes]

I'm not, but I've considered it. I've got similar issues--really long term depression, been on meds for several years. I was taking Cymbalta when I got pregnant, but it's not safe for pregnancy, so I weaned off it early on. My OB said she could give me something else, but then she'd want me to wean off of it a few weeks before birth because apparently one of the problems with anti-depressants in pregnancy is withdrawls in the baby. I waffled about taking something else for a while, but now that the birth is only a couple months away, I'm afraid that just about the time it got built up in my system, it'd be time to get back off it. So I'm just taking it day by day. I take a lot of naps. I'm not getting as much done as I'd like, but thankfully dh has been really supportive.

I do plan to start on Zoloft (or something safe for nursing) immediately after the birth. I know I'm extra prone to PPD, and seasonal depression as well, so I'm just gonna bite the bullet and start on meds right away.

It's a tough decision.

[maisiedotes]

Originally Posted by myjulybabes

I'm not, but I've considered it. I've got similar issues--really long term depression, been on meds for several years. I was taking Cymbalta when I got pregnant, but it's not safe for pregnancy, so I weaned off it early on. My OB said she could give me something else, but then she'd want me to wean off of it a few weeks before birth because apparently one of the problems with anti-depressants in pregnancy is withdrawls in the baby. I waffled about taking something else for a while, but now that the birth is only a couple months away, I'm afraid that just about the time it got built up in my system, it'd be time to get back off it. So I'm just taking it day by day. I take a lot of naps. I'm not getting as much done as I'd like, but thankfully dh has been really supportive.

I do plan to start on Zoloft (or something safe for nursing) immediately after the birth. I know I'm extra prone to PPD, and seasonal depression as well, so I'm just gonna bite the bullet and start on meds right away.

It's a tough decision.

I don't even know what my OB can prescribe- don't some things need to be prescribed by a psychiatrist? I was on prozac last time around and I felt great. The only thing that mattered to me was being pregnant. Now it is just so hard. Tuesday can't come soon enough so I can get some answers.

Thank you both!

[myjulybabes]

Originally Posted by maisiedotes

I don't even know what my OB can prescribe- don't some things need to be prescribed by a psychiatrist? I was on prozac last time around and I felt great. The only thing that mattered to me was being pregnant. Now it is just so hard. Tuesday can't come soon enough so I can get some answers.

Thank you both!

Legally speaking, they should be able to prescribe anything, I think. I got my Cymbalta from my regular internal medicine doc, ds gets Risperdal (classified as an atypical anti-psychotic) from a developmental pediatrician. What they're WILLING to prescribe may vary though, based on his/her comfort level.

Oh, and www.safefetus.com has some decent info. You have to know the name of the drug you're looking for, but then it'll break down what the risks are.

[scheelimama]

There is something called antepartum depression that affects women during pregnancy. It definitely sounds like you would be wise to go back on medication, since it will probably only get worse once you are postpartum. There are several medications that are safe while pregnant. You should talk to your dr./mw about it.

[DeChRi]

There is a great thread in the PPD forum called Pregnancy Depression. There is a lot of advice and many pregnant mamas that chose medication, and lots of med info. Hope that helps!

[Valerieg]

Only you know how to weigh the risk/benefits of the medications that are out there...but judging from your post...something safe for PG/BF might be a good idea (you wouldn't have posted if it wasn't).

Hopefully your dr can find something that is a good fit for you. And I believe any dr can write a prescription for any medication but some are more skiddish about writing prescriptions for things outside their realm of expertise.

GL! I hope things improve for you quickly once you get your answers!

[Curlita]

Big hugs to you, and any other mamas dealing with depression in general, and during pregnancy in particular. Crying and feeling like you are going crazy is obviously not good, and not something you should have to suffer through. If you have been on an SSRI before and know that it helps you, it seems like your OB should be willing to prescribe it again.

I am on 200 mg, the maximum dosage, of Zoloft. This is my second pregnancy on anti-depressants, and I've been on them for over five years. I know what my life was like before being on them. In addition to the depression (which I thought was normal, not having been another way) I had started having massive panic attacks, usually while driving. Going on antidepressants gave me my life back. I was so relieved to learn that I wouldn't have to stop taking them when we were thinking about TTC the first time (at that point I was only on 150 mg, I think).

Studies have shown that the effects of unmedicated depression can be harder on a fetus than the anti-depressents. The constant flood of stress hormones, I think. The side effects I have heard of are withdrawal symptoms and jitters after birth (which I did not notice in my son -- and which I would think might be mitigated somewhat by low levels of the SSRI in breast milk, but don't quote me on that) and an increased chance of persistent pulmonary hypertension, a condition that one study has shown to be six times more common if Mom is on an anti-depressant. Normal rates of PPH are 2 in 1,000; the rate is 12 in 1,000 for babes of moms on SSRIs.

Incidentally, none of my docs or medical providers told this to me -- I did research based on another panicked post on a different board about how antidepressants could harm babies. I'm not convinced that there is enough evidence to prove this conclusion completely; most of the websites you find with information about the links are sponsored by firms that are trying to engage in class action lawsuits against drug companies.

Choosing meds or not is a really difficult and personal decision. For me, frankly, it is a risk I am willing to take because I KNOW what my pregnancy would be like without anti-depressants, and there is an excellent chance that it would prove to be very harmful to everyone involved. I remember being unmedicated, and I frankly never want to be unmedicated again.

Good luck on Tuesday. Let us know how it goes -- hopefully you'll leave the office feeling better.

[Googy]

Hi Maisedotes,
I am so sorry that you have been struggling with this.

I have one question first--have you resolved your thyroid issue yet? I only ask because an out-of-balance thyroid can really affect your emotional health. Actually, depression is often considered the first sign of hyperthyroidism! Your depression may improve significantly after your thyroid is properly controlled. Something to ask your Dr. about.

Here's a good link on antidepressants and pregnancy from the Mayo Clinic:
http://www.mayoclinic.com/health/ant...ssants/DN00007

The botton line is that there are risks to taking antidepressants, though some medications are less risky than others (Zoloft is better then Paxil, for instance). The rule of thumb is generally that is the depression is mild, you should try to handle it with counseling, diet, exercise, etc. If depression is more severe, then it is generally considered better for it to be handled medically, to avoid serious depressive episodes that can be dangerous to mother and baby. Only you can know how serious your depression is, only you can properly weigh the risks and benefits.

Please keep us updated--I hope your appointment goes well on Tuesday!

[TulikaEma]

I am not in this DDC (but should join--I am due in November)--so sorry about input from a total stranger.
First, lots of hugs--I am so sorry that you are feeling this way!

The PPs said pretty much everything I think/ feel, particularly Curlita--but here's my expereince.

I too have had depression since I could remember, and started Zoloft a few years ago (after going though therepy, which helped tremendously). The Zoloft help keep the remnints of my depression at bay--therepy helped my understand why I feel the way I do, and what I can do about it. Z, I believe, helped my brain get its chemestry balanced. When we started TTC, I talked to my doc, who switched me to Prozac for pregnancy. For me and my family, staying on anti-depresants was the best decision I could have made. I eat better, excercise, take care of myself, and am generally more stable on the meds than off--I am sure that its healthier for my fetus to have a momma who is capable of taking care of herself , and that the side effects of no meds (and an unhealthy momma) would be worse than the side effects of the meds.

The decision that you make will be the right one--remember that you know yourself and your needs better than anyone else.

Best of luck, and I hope you feel better soon!

-Heidi

[GinaRae]

I totally agree with getting your thyroid in check. ALSO, visit the chiro and acupuncturist for depression. I cannot tell you how acup. helped my anxiety because it was a physiological issue.

At the point that those don't work or you cannot wait, I would definitely check into meds only because it seems you need to stabilize now before babe is born and the hormones cause PPD.

Good luck, mama! Depression is awful and I suffered for the majority of my life, but as I got older and moved to a sunnier area, mine cleared. Now I just have anxiety and some short periods of depression when things are bad. Acup. helped! I swear to you. Give it a try and see if it can work for you.

[Grace24]

I'm not currently on anything but have been in the past, so to you because I know how debilitating depression can be. I have no advice to offer except to ask for a referral to a psychiatrist who deals with pregnant women, if you can find one in your area, because I know a lot of pregnant women deal with this issue. I know of a couple of women who have been on anti-depressants in pregnancy and had perfectly healthy babies and were even able to breast-feed. So please, get yourself the help you need but go to a reputable psych doctor if you can. Good luck to you and I hope you can resolve this!

[crunchywannabe]

I am not on anything right now either, but I did get severe depression after I went through fertility treatments and finally got pregnant.

I was on zoloft throughout my pregnancy and for a bit into the postpartum period.

I think it is best that you do what you need to in order to feel better. If that is medication/alternative treatments or whatever-do it.

and the zoloft has been shown to be safe during pregnancy AND breastfeeding

[maisiedotes]

Thank you all SO much. I feel much better that I am not the only one! (of course, I don't want any of you to go through it either but ykwim). I am going to talk to my OB first thing Tuesday. I had a functional medicine psychiatrist who has helped me in the past get some of it under control through diet and exercise but it has gotten bad again. I thought I could be off anti-depressants and I did for a while but I think I may just need them right now...

thanks again, everyone. You are all so caring and kind....

[GearGirl]

It is definitely a personal decision, but if I were in your situation I would choose Zoloft. Some doctors will be unwilling to prescribe it simply because there is not alot of information out there, but if you do your own research and make an informed decision I think you can feel good about what you decide. I do believe the stress of depression is harder on a baby than the medication, but with the little research out there you need to decide what you believe.

[Isaac'sMa]

Maisie,
I'm sorry you are struggling with this. I don't have personal experience with this but one of my good friends has struggled with depression just about her whole life and decided to continue taking antidepressants while pg. Her baby girl, now 6 mos old, is beautiful and perfect and sweet and she is a happy, healthy BFing mama still on antidepressants.

While it's obviously a highly personal choice, it seems like it would be worse for both you and your baby if you have ppd than if you took antidepressants (JMO). Other pp have given some good resources for looking into side effects of various meds. Since you've had depression for so long, I imagine you know when you need meds and when you can "live without". If you know you need it, then don't feel guilty. You will be the best mama you can be if you take care of yourself too.
((hugs))

[bgb699]

Big hugs to you Masie
I understand what you're going through. I've been battling depression and anxiety since I was 9. I've been through counseling, alternative therapies, and dozens of different meds since dealing with a nasty bout of post partum psychosis 17 years ago after my first child was born. Counseling gave me the tools I needed to get through situational depression, but the hereditary depressive disorder will always be lurking in the background just waiting for a chance to spiral me downwards.
This is the first pregnancy that I've chosen to stay on anti-depressants with, and I feel guilty about it everyday. I take Prozac 20 mg/day, and even though Safefetus.com says it's a class B drug, I've read sooo many different conflicting reports of it's effects on the developing child. But, I know that if I stop taking it (through past experiences) that it will only be a matter of time before I start shutting out the rest of the world and enter my own personal hell again. So I pretty much feel damned if I do and damned if I don't.
I plan on talking with my doctor about weaning off Prozac around 36 weeks to try and avoid any drug complications with the baby, and possibly starting on Zoloft as I've heard that's safer for breastfeeding.
Talk to your doc about your options. You don't have to feel like this, and when you're armed with the information that you need, then you can make an informed decision. Good luck to you!

[mom0810]

I'm taking Zoloft. I have been since before I conceived this baby. Everything I have read says it's just fine. My OB is fine with it. I am only on 25 mg, but I know lots of women who have taken 150-200 the entire pregnancy and while nursing, and they and their kids are just fine. Perfectly healthy and on track developmentally.

It's a hard choice, but studies have shown that it is more harmful to a fetus to have a depresssed mother than to be exposed to meds. Same thing with babies and kids. So if you feel you need them go for it. There is really no reason not to, and it's important to stay happy during pregnancy.

[maisiedotes]

My midwife last time around had said these things too- that it is more harmful for the baby for me to go through the depression than the effects of the anti-depressants. I can't wait to get in there tomorrow and hopefully get on something.

Thanks everyone!