PP OCD and depression returning-increase Zoloft or switch meds?

[lilysmama1124]

So I have Postpartum depression, PP anxiety, and PPobsessive-compulsive disorder. The PPOCD is actually the hardest for me to deal with because I have reccurrent images of myself harming my dd(9 mos). When they began I started Zoloft and they went away almost immediately. They returned again when she was five months old and I increased to 50mg(I was at 37.5). I recently increased to 75mg due to feeling more depressed(lack of motivation, sadness, insomnia) but have now been having the troubling thoughts again. I don't feel that I am in any danger of actually harming my dd but the thougths are so scary and upsetting. It was such a relief when I learned thatthese thoughts are pretty common in ppocd and rarely result in the mother harming their baby and are not a sign of pp psychosis.

So I am trying to decide between upping to 100mg of Zoloft or switching to a new med. The Zoloft has worked pretty well so far at the lower doses and I hate to expose my dd to a new med butthe symptoms do return so maybe I should try something else. I guess I just needed vent a bit-this is just so hard to have recur at this stage. I'm sure some of it is that she is teething and very fussy and mobile so it is harder for me to take breathers when I need them.

I do have a health care professional that I can talk to about switching meds but it such a guessing game for them with ppd and meds that I am interested in other's feedback. I also have a therapist who is a good support.

[Individuation]

Studies done by Pfizer indicate that Zoloft isn't significantly more effective at higher doses than 50mg. There's some good info on Zoloft here.

[FitMOmmyOf2]

Originally Posted by Individuation

Studies done by Pfizer indicate that Zoloft isn't significantly more effective at higher doses than 50mg. There's some good info on Zoloft here.

Wow, that was a very good link you gave here, thank you so much! I needed to read up a lil bit more on Zoloft myself and am happy having come across your link!

To the OP, I honestly have no idea. I'd really talk to your Doc and see what he/she says!..
Good luck and (((hugs))) mama, hang in there!!!

[Irish_Blue]

I had pp OCD with my 4th son, I'm so sorry your dealing with this too it can be such a scarry thing. In everything that I've read I've yet to come across an account of someone with OCD actually acting out on any of their thoughts, I found that comforting.

I tried to go on zoloft and it actually made things worse for me, so I am glad that it has been at least somewhat helpful for you. I wish I had an answer as to how to deal with it better ~ I take a lot of supplements like my Omega efa's, I had to cut out ALL caffine b/c it made my anxiety a lot worse.

I've recently decided to go to counseling to help & so far it's proven to be very helpful, I also realized that my ocd had a lot to do with my past too, not something I would of thought of. Anyhow ~ a book I found helpful that I've read recently was called Imp of the Mind which speaks about pure-o OCD, perhaps you might find it helpful too.

(((((big hugs mama))))))

[mom0810]

Have you read the book Brain Lock? It is about OCD and will help you a lot with those thoughts. The key is to NOT try and fight them. Let them come in, and let them go out. One of the key factors in OCD is that if you fight the thoughts, they just get stronger.

As far as the Zoloft, I would think if it is working for you, you could increase the dosage. Some people need to take 150 mg or more to get help.

Do you have a good therapist? There is a GREAT one for PPD here in Illinois, if you are willing to drive to her. She is the head of the Postpartum support Alliance in Illinois, and she is a published author. Really has helped me with my symptoms. If you check out the Postpartum Support International, you will find the link to Illinois and several therapists who specialize in this. PM me if you want more info.

since the zoloft worked so well for you, I would be inclined to stick with it. But that's just me. there are lots of other meds and maybe you could try one that works on other neurotransmitters, not just serotonin.

Hope this helps, and good luck.

[iluvmy3girls]

Reading this post has made me realize, I'm not the only person experiencing this. B4 I conceived I got off Paxil and switched to Prozac, mainly just didn't feel it was working enough, and I had been on it for 4 years. I was in the process of transitioning to Prozac when I conceived. My depression flares up during pg, and can get a little out of control. The OCD thoughts are probably driving me the most crazy, irrational stuff that I worry will happen. I'm thinking of going back to my therapist. I'm at 40 mg of Prozac and really don't want to have to increase, unless absolutely necessary.

[lilysmama1124]

EMDR therapy really helped me during and after mt pg. I'm unfortunately running out of appointment on my insurance so I can't really start doing it again.

[iluvmy3girls]

Originally Posted by lilysmama1124

EMDR therapy really helped me during and after mt pg. I'm unfortunately running out of appointment on my insurance so I can't really start doing it again.

What exactly is that?

[Adele_Mommy]

50 mg of Zoloft is a good dosage for depression, but for OCD people frequently need a higher dose. I have OCD (not pp though) and I take 125 mg. When I started taking Zoloft I had depression as well and I increased dosage very gradually. At 50 mg my depression was taken care of and I felt so much better I felt like my OCD had improved as well, but my therapist said 50 mg isn't really enough to address OCD, it was just fixing the depression, when made me much more able to deal with the OCD. The study referenced previously just means Pfizer, who makes Zoloft, has not done any studies to prove higher doses are more effective. They haven't done any studies that show higher doses are not more effective either. I would try upping your dose of Zoloft before I tried switching meds.

Good luck!

[mom0810]

Very good point, Adele. I know many people who were not okay until they went up to 150 or so, either, and some to 200. It really depends on your chemistry.

The book, Brain Lock, also points out on brain scans the difference between people's brains with OCD and without. It's really fascinating. The meds help fix those parts of your brain, make them less active, and if you have OCD you know this is a good thing. It has some great analogies in there, and talks about how meds and therapy together have a 90% effectiveness rate, while one or the other is only 50% or so effective.

The meds are like "water wings" while learning to swim. They help support you so you can do the therapy and then things get better until you don't need the meds anymore.

I think going up in dosage is very appropriate rather than switching meds. Another med may not work as well, or it may have side effects the OP is not used to.