Antidepressants and Pregnancy
I have been taking antidepressants for almost 5 years. Looking back at my life, I see there were other times I would have benefitted from antidepressants, from that support. The fact that I made it through without isn't a sign of strength, truth be told I was scared. Scared of not being myself, of relying on something outside of myself, of never being able to come off. I wasn't in a place to see how much I was struggling, not thriving. I have a very strong family history of mental illness, I have experienced the loss of my sister at the age of 15 and on top of this, I wonder if I am one of those people who may have a chemical imbalance, who may always require this support ongoing...
I had formed a connection with my GP and she continued to challenge my fears around these drugs, and she encouraged me to see a psychologist. This psychologist wanted to explore some areas in my life, but felt she couldn't push me too far to explore as I was a "ship in the ocean", very susceptible movement. She explained that the antidepressants would move "my ship" into the dock. She could challenge me, get me explore more deeply each session. These drugs would be my cushion to allow me to continue to function in my life.
I started taking Effexor (venlafaxine), which is in a group of drugs called selective serotonin and norepinephrine reuptake inhibitors (SSNRIs). This worked very well for me. It was a light turned on. Getting out of bed was no longer a chore! Not sure if it's not right to say, but I loved them!!
However after working with the psychologist I decided it was time to try and get off them. I transitioned to Zoloft, as the side effects of Effexor withdrawal were horrible. I am now fully transitioned to Zoloft (don't love it as much as E!) and exploring whether I should come off prior to getting pregnant. I'm no doctor so following Infirmation is taken from the Mayo Clinic.
If this is something you are also exploring, in the first instance, please make sure you are talking the process through with your GP and or psychologist.
How does pregnancy affect depression?
Pregnancy hormones were once thought to protect women from depression, but researchers now say this isn't true. In addition, pregnancy can trigger a range of emotions that make it more difficult to cope with depression.
Is treatment important during pregnancy?
Depression treatment during pregnancy is essential.
If you have untreated depression, you might not seek optimal prenatal care, eat the healthy foods your baby needs or have the energy to care for yourself. You also might turn to smoking or drinking alcohol. The result could be premature birth, low birth weight or other problems for the baby — and an increased risk of postpartum depression for you, as well as difficulty bonding with the baby.
Are antidepressants an option during pregnancy?
A decision to use antidepressants during pregnancy is based on the balance between risks and benefits. Overall, the risk of birth defects and other problems for babies of mothers who take antidepressants during pregnancy is very low. Still, few medications have been proved safe without question during pregnancy, and some types of antidepressants have been associated with health problems in babies.
Which antidepressants are considered OK during pregnancy?
Generally, these antidepressants are an option during pregnancy:
Certain selective serotonin reuptake inhibitors (SSRIs). SSRIs are generally considered an option during pregnancy, including citalopram (Celexa), fluoxetine (Prozac) and sertraline (Zoloft).
Serotonin and norepinephrine reuptake inhibitors (SNRIs). SNRIs are also considered an option during pregnancy, including duloxetine (Cymbalta) and venlafaxine (Effexor XR).
Bupropion (Wellbutrin). This medication is used for both depression and smoking cessation. Although bupropion isn't generally considered a first line treatment for depression during pregnancy, it might be an option for women who haven't responded to other medications or those who want to use it for smoking cessation as well.
Tricyclic antidepressants. This class of medications includes amitriptyline and nortriptyline (Pamelor). Although tricyclic antidepressants aren't generally considered a first line or second line treatment, they might be an option for women who haven't responded to other medications.
Which antidepressants should be avoided during pregnancy?
The SSRI paroxetine (Paxil) is generally discouraged during pregnancy. Some research suggests that Paroxetine may be associated with a small increase in fetal heart defects.
In addition, monoamine oxidase inhibitors (MAOIs) — including phenelzine (Nardil) and tranylcypromine (Parnate) — are generally discouraged during pregnancy. MAOIs might limit fetal growth.
Should I switch medications?
The decision to continue or change your antidepressant medication is up to you and your health care provider. Concerns about potential risks must be weighed against the possibility that a drug substitution could fail and cause a depression relapse.
What happens if I stop taking antidepressants during pregnancy?
If you stop taking antidepressants during pregnancy, you risk a depression relapse. In addition, stopping an SSRI abruptly might cause various signs and symptoms, including:
Nausea and vomiting
Chills
Fatigue
Anxiety
Irritability
What's the bottom line?
If you have depression and are pregnant or thinking about getting pregnant, consult your health care provider. Sometimes mild to moderate depression can be managed with psychotherapy, including counseling or other therapies. If your depression is moderate to severe or you have a recent history of depression, the risk of relapse might be greater than the risks associated with antidepressants.
Deciding how to treat depression during pregnancy isn't easy. The risks and benefits of taking medication during pregnancy must be weighed carefully. Work with your health care provider to make an informed choice that gives you — and your baby — the best chance for long-term health.
Remember, you are your baby’s most important asset, and an asset that should be looked after — caring for yourself is as important as caring for your baby.