SSRIs and Pregnancy/Breastfeeding

posted 11 months ago in Pregnancy
Post # 2
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915 posts
Busy bee
  • Wedding: January 2017

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loudsilence99 :  I take Zoloft for bipolar disorder, and took it through my first pregnancy and breastfeeding. I ultimately quit breastfeeding at 6 weeks for supply issues, but my psychiatrist said that Zoloft is very safe for both pregnancy and breastfeeding. For me, the potential risks are negligible compared to the risks I put myself and baby for if I have a major depressive episode during pregnancy or untreated PPD. I worked closely with my psychiatrist to make sure I was taking the minimum therapeutic dose so I got the benefits I needed with the lowest possible risk for pregnancy. 

Post # 3
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117 posts
Blushing bee

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loudsilence99 :  So just my experience obviously but – in case it is helpful or reassuring

I have OCD and MDD and find things much more managable with a low daily dose of citalopram (20mg). Before we started TTC I discussed with my OBYN and a pyschiatrist and both agreed it was going to be better and safer for both me and baby to be on the medication vs. off. Side effects we were made aware of were similar to what you have stated for Prozac – primarily breathing issues at birth and a risk of irratability/feeding issues for the first few days/weeks – with no long term negative effects for the baby.

We decided to go ahead and stay with the medication. Our daughter did have breathing issues at birth – though it is impossible to say if that is from the citalopram or because she was induced early (I have T1 diabetes, which also increases the risk of breathing problems at birth) – but it was not serious enough to panic any of the staff at the hospital. They took her to the NICU, gave her a bit of O2 to help her lung fully inflate, and it didn’t take long for her to stabilize. We also didn’t notice any particular irratability or feeding/sleeping issues (she has actually always been an amazing sleeper) and I also breastfed for a year (while taking medication). Long story short, I am now pregnant with #2 and still taking the citalopram.

For me, after discussing with my doctors I felt pretty strongly that the increased stress and anxiety during the pregnancy was likely going to be more damaging to my health (even just in my ability to properly prepare for the arrival of a tiny human!) and the baby then taking the medication. I would encourage you to talk to your doctors about what the safest options for you are – be that prozac or something else – before starting TTC so that you can make any changes necessary and then head into the pregnancy feeling stable and prepared. Also – no matter what you decide to do – please remind yourself that this is medication you take for an illness and should be treated that way (as in, discussed with your doctors and then decided based on medical need and effects). Anything that suggests that you you should stop taking the medication because you “are choosing to take it and don’t HAVE to” is garbage.

Post # 4
Member
566 posts
Busy bee
  • Wedding: June 2017

I was prescribed a low level of Zoloft around 7 mos pregnant with my third because I was starting to have anxiety and had suffered significantly with my first two and PPD. My OB felt it was perfectly safe, and I continued taking it until my son was around 3 mos and I felt “back to normal”. No issue. My husband is a pediatrician, and wasn’t at all concerned. I can tell you, having been twice pregnant, and breastfeeding twice without meds and then once with and breastfeeding with- our third (who I was medicated with) was the most mellow and is sincerely a very happy baby. No untoward side effects to speak of. So I’d say, take care of you, and good luck!

Post # 5
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5551 posts
Bee Keeper
  • Wedding: October 2017

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loudsilence99 :  my prescriber weans me from the medication about three weeks before my due date so the baby isn’t born addicted to it.

I had a horrible time coming off of cymbalta during my last pregnancy, it was so bad that I refused to ever go back on it, so she put me on Zoloft for the rest of the pregnancy 

We have talked about Prozac, from what my prescriber says, Prozac is self tapering, so the baby will self taper after it’s born and shouldn’t go through withdrawal. My Wellbutrin doesn’t do that though, I will be weaned off of that before the baby is born

This is my doctor though, find someone who is very knowledgeable about the medications as well as how they impact a pregnancy and newborns

Post # 6
Member
1248 posts
Bumble bee
  • Wedding: September 2017

Any reason you wouldn’t consider formula? No snark. It just seems like the obvious choice to me? So you can continue your anxiety meds. 

Your mental health is more important than being able to say you breastfed. The baby won’t know the difference. 

Post # 8
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893 posts
Busy bee
  • Wedding: August 2015

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loudsilence99 :  I am not a gynaecologist/ obstetrician, but a family doctor/ GP. I have seen many patients on SSRIs throughout pregnancy and counselled a few others on SSRIs in pregnancy  (most opt to stay on them). I’ve yet to see an adverse outcome. 
On a personal note, from someone who has slightly anxious tendencies but I’ve never been bad enough for any form of therapy or medication, my anxiety has RAMPED up big time in pregnancy. So I would say for MOST people, it is way more beneficial to stay on your SSRI at the lowest tolerated dose, than to experience a relapse when it is already a very stressful time. 

Post # 10
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1276 posts
Bumble bee
  • Wedding: May 2014

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loudsilence99 :  Hi Bee! I take a low dose of sertraline (Zoloft) for OCD and a raft of other concerns. My psych specifically chose it over prozac when she learned we were thinking of TTC. She said that prozac wasn’t good for pregnancy, but I have no idea what that was based on. 

Since you say your current med might not be doing the best for you, a change might not be such a bad thing! But what my psych said is only one professional opinion – your doctors may think otherwise.

Either way, I completely agree with what others and you have said. Protecting your health, mental and physical, is the safest thing for your future baby. Once you’ve cleared things with your doctors, don’t waste a second feeling guilty or second guessing your decision. 

Post # 12
Member
1430 posts
Bumble bee
  • Wedding: August 2014

I’m on lexapro and lamotragine and am TTC. I got off the benzo I was on, but my doc told me she felt much more comfortable with me staying stable on meds that are likely not problematic for pregnancy than grow my baby in unchecked amounts of cortisol. I think it’s most important that mama is stable!

Post # 13
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9057 posts
Buzzing Beekeeper

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mrscb2bee :  
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loudsilence99 :  breastfeeding can also help stabilize your hormones and moods after birth so that’s another consideration. I was having a lot of difficulty with breastfeeding (low supply that took 2 months to fully come in) but it was really important to me. The ONLY reason I considered quitting was hoping it would help with my mood swings but multiple medical professionals told me the mood swings post-weaning were likely to be worse so I decided to stick with it. My friend who formula fed and had PPD with her first is considering breastfeeding her second in hopes of smoothing out that emotional rollercoaster. Obviously it’s not a replacement for medication though. 

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