Depression Answers

Antidepressants and Pregnancy ?

Q.We're thinking about #3 (as surprising to us as to everyone else!). I have been experiencing episodic depression for all of my adult life, and this past spring, during my fourth and, to-date, worst episode, I started taking an SSRI. I seem to be back to normal now, and have been stable about a month or two. However, while I know I'll feel great during pregnancy (pregnancy and lactional amenorrhea are high-points for me mood-wise), I'm more than a little frightened of weaning off my SSRI and the period between that and conception resulting in the dreaded downward-spiral. (In the past we have conceived immediately, but because our schedules no longer mesh as well, we may not be able to do the deed at the appropriate time this time around.) Does anyone have any experience with taking SSRI during early pregnancy? I am confident about weaning *after* conception, but would like to know my estrogen levels (which I suspect, due to several bits of evidence, as the culprit for my mood disorder) are in check beforehand.

A.Basically what I was wondering was if it was safe to take the medication until I get pregnant, rather than trying to be med-free before we start trying, and you seem to have answered that. Thanks very much! Good to hear pregnancy does as much for you as it did for me...hope you have continued happiness! I was on Zoloft and Buspar when I got pregnant. Buspar is an antianxiety drug with no dependency, and I dropped that cold turkey. The zoloft I managed to wean down to 25 mg. (from 100) but could not get off it completely until I was into my second trimester (the withdrawal was too rough when combined with first trimester pregnancy sickness). I had a healthy baby girl, 9 lbs. 11 oz. She was (and still is) an enthusiastic nurser. When she was about 8 months old, I went on Paxil, and I have seen no side effects in her. I was *told* by some of the LCs at the hospital that I wouldn't be able to nurse my son if I went back on Prozac (which I was considering doing at the time because of severe PPD), so I tried to tough it out for a few weeks, until my endocrinologist basically told me to ignore what I was told and start taking the meds again. This time, with my daughter, I never stopped taking Prozac during the pregnancy, and I continue to take it and nurse. FWIW, I never had any PPD after her birth, and I attribute that to the Prozac. When my youngest was almost a year old, I was hit with PPD. I was nursing her and also a step-son, but needed the meds to save my life. It was before the days of Prozac and Zoloft (she is now 14), so they gave me Elavil. While the literature said to wean, a wonderful breastfeeding counselor and advisor to La Leche League told me I could continue nursing with no problems, so I did. Neither child has had any problems with depression as they are growing up... and neither showed any side effects while I was nursing them. Since that time, I have worked with many women with clinical depression and pregnancy as well as women with PPD (I have been a Doula for 18.5 years) and most have continued their meds during their pregnancy and breastfeeding. The benefits *far* outweigh the risks of not taking the meds.

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