I need some help and at this point I have NO idea who to get some decent advice from.
I've dealt with depression since I was about 18 years old. It sucked, bad. I did therapy, I was put on Celexa. I have felt NORMAL for the past 6 years. Celexa works well for me, no side-effects. I have tried multiple times (about every 6 months, lol) to wean myself off of it (I'm at 20mg/day), and every time I drop below 20mg we really notice it. I am sad that my body is unable to handle it without this drug, I HATE taking drugs, but this is one of those cases where on the medication is most definitely better than off of it.
So before I got pregnant I talked with my old OB. He looked up research and we had a lengthy discussion about SSRIs and Celexa and he said in his opinion I should stay on the Celexa during pregnancy, that the studies are not showing any harm to the baby and that it is certainly better for me to be on this medication and mentally and emotionally stable than being off it. All is good. I've stayed on the Celexa, my mood is still stable as ever, even with pregancy hormones thrown in the mix, all is well.
The PROBLEM is breastfeeding. I of course always do my research on everything, and found that Celexa is passed into breastmilk in higher quantities than other SSRIs. At this point I have switched practices to an all-midwife practice that encourages and supports natural childbirth. So I bring up the medication issue with them.
And this is where I get frustrated. I have seen multiple midwives at this practice and I have asked every one about the celexa. I get a, "Well, they're all SSRIs, they're all going to be in breastmilk, celexa is fine to stay on" offhand response (so they obviously have not read up on it) and/or a "we'll check into it." and then next visit? The midwife is as clueless as ever and there seems to be no note in my chart of them saying they'll check into it. They are really very dismissive of this issue and I am BEYOND frustrated trying to get any kind of direction from them. They say, "Ask the baby's pediatrician." ARRGGGG.
The one midwife who DID seem to take it seriously expressed concern over me switching medications at a time when I am at a high risk for post-partum depression anyways. Her concern was valid, and it's a concern of mine too - celexa works WELL for me. Some women have to try three or four different drugs to find what actually works for them. I do not want to be messing around with my medication after the baby is born. And I am nervous about switching things up now, too. I am stable on the celexa... do I REALLY want to mess with that?
What the heck should I do? I know the facts in that celexa is higher in BM than, say, zoloft, and zoloft is the first drug recommended. But the midwives did point out that many women do BF while on celexa. Plus the whole do-I-really-want-to-mess-with-this thing. I do NOT want to be having a mental breakdown right before or after my beautiful baby is born.
I really feel like I need some professional advice, and my midwives are simply not providing it in this case - I just don't think they are educated enough in anti-depressants and breastmilk to be able to. So who should I ask about this?? The baby's ped? An LC? An OB? Which OB?? (My original OB, by the way, whom I liked so much, has since left that old practice. So I can't even schedule a second opinion with him.)