Antidepressants during pregnancy/breastfeeding

[hopedance]

I have recurrent depressive episodes. They are severe (the kind that last a year or more, and leave me suicidal, unable to work or study or even get out of bed), and reoccur. I've been hospitalised on multiple occasions because of this.

I have now been stable and well on antidepressants for 12 months, and it is the first time in my life I have felt 'normal'. I told my GP I wanted to get pregnant, and he basically said, yes there is a risk to the baby if you stay on your medication, but it is a really small risk, and much smaller than the risk of you getting ill again if you come off your meds.

I told him that I wanted to try coming off them anyway, and he reluctantly agreed, saying that I could always go back on them again. So I moved down to a 40mg dose (I take cymbalta/duloxetine - an SNRI) from my usual 60mg, and I am due to go down onto 20mg next week.

The problem is, I am already starting to feel depressed again, my concentration is shot, I'm tearful and unmotivated to do anything, I'm tired and just keep going back to bed and sleeping instead of doing my usual daily activities.

I know the sensible thing to do is go back up to the 60mg dose, and stay on that throughout pregnancy - but what if I get my BFP, and then the baby dies or is ill because of my medication?

Is there anyone here who has stayed on medication through pregnancy that posed a risk to the baby? Or any insight or wisdom about what I should or could do? I'm seeing my GP on monday and need to make a decision.

 

[ald]

Hello, sorry to hear you are feeling really bad, you need to look after yourself otherwise depression in pregnancy is good either. I was on strong antidepressants as well and it took me about 5 months to get off them. I did it very slowly and gradually for example my dose was 80mg, so when i started to come off them I did 80mg for 2 days and then 60 mg for one day and did this dose for a few weeks then I went down to 80mg for 1 day and 60 mg for 2 days, and then 60 mg each day and just kept cutting down like that. I admit it took ages and if I found i was starting to feel depressed I just went back up one level to see how i was then. Then tried cutting down a few weeks later again. It may be worth talking to your doctor to see if the same sort of approach would be better, a it leaves your body slowly then getting you use to the change. If you want any more info please pm me.

 

[Sovereign]

Hi.

I have been on antidepressants all through my pregnancy but on Fluoxetine which is supposed to be safe during pregnancy and breastfeeding. x

 

[asacia]

I came off Cymbalta when I got pregnant. My Pyschiatrist said I could try one of the safer anti-depressants if I wanted - perhaps that would be an option for you?

I took Cymbalta (60mg) for the first 12 weeks of the pregnancy. I'm off it now, and so far things look alright. That said, I do worry about it, and whether any damage is done. Worry isn't really the best of things, especially with someone with depression.

 

[hopedance]

thank you all for your replies.

as far as I can tell from googling, cymbalta is riskiest during the last trimester, so asacia, you and your baby should hopefully be fine since you are off it now. did you find it hard to come off? have you started to feel depressed again at all?

i think you guys are right, a safer anti-depressant may be something to try. i am a little wary of fluoxetine, as i went on it once a few years back and it made me very agitated, but perhaps it would have a different effect now i'm used to antidepressants.

it's so hard to make a decision, so hard.

 

[asacia]

My Pyschiatrist advised that I came of Cymbalta as soon as possible, and I did have pretty bad withdrawls for about 2 weeks. My mood has been alright, the depression has been a lot better since I got pregnant. I'm doing 'okay' and at the moment everyone is happy for me to carry on without medication.

It was a difficult descison, because I've been on a lot of medication in the past (I think Cymbalta was my 9th attempt) and it was the only thing that had a positive impact. I'm wary of SSRI's because I had a bad reaction to a couple of them.

Have you looked at non medication based treatment? Perhaps a course of CBT or Pyschotherapy before you concieve would help?

 

[reallytinyamy]

I have bipolar disorder and came off cymbalta and seroquel to get BFP. I went on fluoxetine and olanzapine and had a healthy baby, I went through all sorts of worries and questions.

Please feel free to PM me if you want any advice, have questions or want to chat

 

[hopedance]

yes I have, i have just finished almost 18 months of weekly CBT sessions, they were extremely helpful for my PTSD, but had rather less effect on my depression. my episode of depression one before last, I had a depression specific course of CBT too, which did help, but really just through managing the depression rather than improving my mood substantially.

I've taken antidepressants before which gave me a bad reaction. I think I had fluoxetine, then sertraline, then venlafaxine, each which caused increasing agitation, it got so bad in the end that was when I was hospitalised and given an atypical antipsychotic purely for the sedative effect to get rid of the agitation. I swear I took more antidepressants than that, but I've forgotten now!! I was adamant after that that I would never take antidepressants again, but in the next episode when I was suicidal again and the CBT wasn't helping, I gave in and eventually took cymbalta and it was a lifesaver, really.

I suppose I am wondering if I should transfer onto fluoxetine and see if perhaps now I am used to having antidepressants in my system, I might not react so badly to it this time?

 

[hopedance]

reallytinyamy - i will PM you, thank you

 

[reallytinyamy]

reallytinyamy - i will PM you, thank you

No problem!!

 

[Chris77]

Hi.

I have been on antidepressants all through my pregnancy but on Fluoxetine which is supposed to be safe during pregnancy and breastfeeding. x

I'm with Sovereign. I'm not pregnant nor have I ever been, but I am currently TTC and I'm taking Prozac (fluoxetine) and my doctor told me that is safe during pregnancy and breastfeeding.

I'm sorry you're having to deal with depression right now.

 

[TiaSunset]

I've been on 100mg Sertraline for about a year and half and I'm pregnant, only 33 days to go.
I let my GP and psychiatrist know as soon as I could after falling pregnant and they said the effects are of Sertraline during pregnancy are unknown but if there is any damage then it should show on the scans and any damage would of been done by the 12th week.
My midwife also knows and she's fine about it, they said they would be more concerned about my health if I stopped taking them.
Luckily all my scans and checks ups are fine.
My next appointment with my psychiatrist is 9th January and he said he will look into me coming off them then if I feel well enough to, by then I will have had Jake.

Try not to worry too much hun.

Wishing you the best of luck with everything
x

 

[Sam86]

Hi.

I have been on antidepressants all through my pregnancy but on Fluoxetine which is supposed to be safe during pregnancy and breastfeeding. x

I'm on that too and have been for almost 2 years now. When i M/C i asked my GP if my med's may have caused it, but she said that she knew of many women who were on fluoxetine and went on to have a normal, healthy pregnancy.
x

 

[BurtonBaby]

I am also on Prozac, and have been since shortly after having my daughter, with BFing, and it has been safe. Sorry you are having a hard time.

 

[eclipse]

I just have a quick story to make you hopefully stress a little less. My sister in law is now pregnant with her 3rd child. Through all of her pregnancies, not only has she been on anti depressants, but she has been on anti-psychotics, and smoked, though she cut down. She tried to stop and spiraled down so fast her doctor said the risk of going off was higher than that to the baby. They monitered her pregnancies very closely, and she has a beautiful 5 year old, almost 4 year old, and is 20 + weeks with number 3 and no problems. She couldn't bf, but she said that was a small price to pay for her sanity.

I think your doctor may be right on this one, I would stay with what you are on at the dosage you are on and talk about SLOWLY switching over to something else if you both agree that is a good idea. Talk to your doctor, be open and honest with your concerns and how you are feeling. If you are not doing well, that puts everything at risk.