antidepressants in pregnancy and baby's withdrawal?

[Mama to EllieCat]

I don't post much, but could really be helped by picking the brain of a few other mamas who have been in a situation similar to mine.

I think I need to start on an antidepressant. I took one for PPD after my DC was born. I only used it for 6 mos or so- I thought I was over the hump and weaned off- this was over a year ago or so. I've been trying to hold off from starting again, but I see things spiraling out of control. My depression/anxiety influences my level of patience with my sweet almost 2 year old DD. I've tried counseling with a career counseling, thinking my job was part of my problem and I have tried to exercise more regularly, but I am not getting anywhere. Therefore, please don't suggest vitamins/exercise along the vein of Tom Cruise's philosphies.

I have an appt with my primary care doctor today. I hope to get a referral to a good therapist and maybe start on meds today. I'm also thinking of waiting to have a therapist start me on meds, just not sure my PC doc is the right one for this.

This leads to my question: I am actively TTC and the idea of going on an antidepressant has me worried. I know the risk of congenital abnormalities are rare with SSRIs, so I am not worried on that front.

I *am* concerned about my baby going through withdrawal symptoms after delivery and there being complications. There are studies out there addressing this issue and it does occur. I am also worried about long term effects on my DC's brain development/IQ/mental health from being exposed to these drugs in utero. There are not as many studies addressing this.

Any thoughts/musings?

Thanks in advance for your thoughts. I sincerely hope I haven't frightened anyone.

Kristen
Mom to Ellie 8/8/03

[Saartje]

Well, I was on Zoloft before, during, and after pregnancy. This is anecdotal, of course, but I had no problems at all, and Ishie didn't seem to have any, either; he was a perfectly happy newborn.

As far as long term effects from exposure in utero, frankly, I (and my OB) was much more worried about the long-term effects on Ishie's mental health if he was exposed to the mood swings that I undergo when not on medication. I find the studies suggesting that children born to depressed mothers are much more likely to be depressed far scarier than theoretical damage that could be caused by the medications, when what data there is (that I have seen) does suggest it's reasonably safe.

[barbarhow]

I don't have alot of time to answer right now but will start and write more later-
If you are planning to breastfeed-your baby will continue to get small amts of med in the breastmilk so the belief is that the withdrawal is negligible. Certain meds are tolerated better than others and excreted in smaller amts such as Zoloft. Lexapro has been found to cause lethargy in newborns, Prozac can cause agitation in newborns. Zoloft is believed to be the best tolerated antidepressant for breastfeeding infants.
The guidelines I follow in my practice is that if a patient has a history of major depression she is generally started on an antidepressant in the 3rd trimester as she is considered high risk for recurrence of the depression. HTH
Barbara-mom to Jack 3/27/03, a Red Sox fan
and Anna 5/12/05, my little Yankee fan!

[crayonblue]

Kristen,

There is a recent post discussing pregnancy and antidepressants.

http://www.windsorpeak.com/dc/dcboard.php?az=show_topic&forum=37&topic_id=227865&mode=full&page=

I wasn't on antidepressants during my first pregnancy but most likely will be during second. Also, I breastfed my daughter while taking antidepressants and didn't notice any side effects.

I totally agree with Saartje on this one. My mom was depressed for most of my life and suffered 18 months of PPD after she had me. I have three younger brothers and all 4 of us have dealt with depression. I am more concerned about the effects of being raised by a depressed parent than the effects of antidepressants in utero and passed through breastmilk. I truly hope I am not wrong on this one.

Good luck!

[Tondi G]

I started meds after pregnancy #2 so I can't say anything about the effects to my boys. I do know that my SIL started on Celexa when her 1st was 6 months and nursing and it didn't effect her daughter at all. Then when she was pregnant with #2 she started back on the Celexa about 6 weeks before her second daughter was born and then was breastfeeding. She said she saw no difference in her second and was so pleased with her decision. She didn't want to go through PPD again!

I am on Lexapro and am SOOO happy with this med. It's basically a newer version of Celexa without the added inactive ingredient. My Psychiatrist said it has less side effects. I spoke with someone who suffered with panic attacks/anxiety her whole life and has tried all the meds.... zoloft, Celexa, Paxil, Wellbutrin and she has felt the best and had the least side effects with the Lexapro!

this is a great site with good info

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

Hugs and Good Luck

~Tondi
Mommy to Mason 7/8/01 and Aidan 5/4/05

[dianna]

I am also on Lexapro, and was before my pregnancy and now during. I consulted 3 docs about it, including one psychiatrist, and all 3 felt that it was perfectly safe to take.

Once i hit my second trimester I was feeling better than I ever felt on the antidepressants (my doc said it's called "Pregnancy Prozac!" and its better than any drug), however my doc wants me to continue taking the Lexapro because after delivery all those great hormones are going to crash.

He said the biggest problem is that antidepressants tend to take away the irritability of infants. And irritability is what makes humans sleep, eat, cry, etc. So sometimes infants will not have the urge to eat like they should. He said that isn't the end of the world, and is usually a temporary situation until you can get them on track.

[Mama to EllieCat]

Thanks for all of the replys! I really appreciate it. Everyone has made some great points and I really feel I need to start on the meds and remain on them for longer than I did with the PPD.

My doctor prescribed Celexa. She also gave me something to use as needed for anxiety, but I don't think I am interested in getting it filled.

She also gave me the name of a therapist. Unfortunately, I live in an area where psychiatrists are few are far between. Let's hope we don't have to play around with meds and doses. My doctor even admitted she wasn't well versed prescribing these drugs in difficult cases and would love to send me to a good psychiatrist if she knew of one.

Thanks again.

Kristen

[Elilly]

I started on an antidepresant when I was about 5 months pg with Graham. His triple marker came back elevated for spina bifida and Colleen was being worked up for CF. It was just way more than I could handle. I stopped taking them when he was about 1 month old. I did not notice any withdrawal sx from him. To be honest, I have mommy brain right now and can't even remember what I took. If I can find a left over bottle, I'l update my post. HTH.

[alkagift]

Kristen,
I just saw this and wanted to point you to a few links that I found very helpful. One of the best resources for me has been the research of Zachary Stowe, MD on Women's mental health. Here are a couple of links to research that might help you:

www.pregnancyanddepression.com (heavy research)

www.emorywomensprogram.org

Allison
Mommy to Matthew, who is TWO!