Pregnant - meds - advise zoloft

[ialford]

Hi,
Just found out that I am 6 weeks pregnant. I suffer from Anxiety and Panic attacks. I decided that I did not want to go down the route of meds and have seeked out private CBT theraphy instead. The pregnancy is making my anxiety/depression worse and I feel I can't cope....Im worried that I will harm the baby with all this anxiety. I also have a 2 year old to look after. I think it would be best for me and my baby if I took meds so I was calmer. I heard that Zoloft was a good SSRI while pregnant - can anyone tell me if they have any experience or advise with this? Thanks,

[Asha1979]

Hi I cant tell you much about zoloft although I have heard it is one of the safer ones during pregnancy. I am currently taking citalopram and am 7 months pregnant and all is fine

[ialford]

Hi I cant tell you much about zoloft although I have heard it is one of the safer ones during pregnancy. I am currently taking citalopram and am 7 months pregnant and all is fine

I was told by my doctor that he prefered I took NO meds at all. ???

[craasch210]

I dont want to scare you, or fill you with bad information. I am very new to this site, so take what I say with a grain of salt.

The studies involving SSRI use during pregnancy are fairly new and still evolving. It is difficult to study, because most (maybe all) of the studies have been retrospective in nature. This is makes it difficult to control variables and are therefore not as reliable as prospective studies. In simple terms, researchers are forced to just group women together who have had babies and also happen to have been taking SSRI's, since they are unable to take a similar group of women who are pregnant and then just randomly give them an SSRI to see what happens. Because of this, it is really difficult to say how reliable these studies are.

For example, Lets pretend that we did a study of women who have a certain condition called "alien from mars disease". In this study tylenol, was one of the most common drugs used to treat this condition effectively. Now scientists perform some evaluation of the numbers and discover that pregnant women who have "alien from mars disease" and also take tylenol, are 700% more likely to give birth to babies with birth defects. Many will now jump to the conclusion that tylenol use causes birth defects. It will be posted all over the internet and there will be lawyers on TV commercials telling you to sue the makers of tylenol, because it caused your baby to have a birth defect.

The problem with this scenerio is this. Maybe, we looked at the data wrong. And as it turns out, "Alien from mars diseas" causes some malformation of the uterus (or whatever) that leads a lot of babies to have birth defect. It was only a coincidence that these women also happened to take tylenol. And we then learn that tylenol actualy has no effect on the rate of birth defects.

This is kind of a far fetched idea, but it is similar to how studies on SSRI's are performed in many cases. The researchers try to control the variables, but time and time again, we find new studies that explain away the incorrect results of other studies. This is the inherent problem, when you are unable to perform prospective randomized research, because the study itself might cause harm to the patients.

There are many studies out there, but most have come to similar conclusions. The use of SSRI's during pregnancy appears to increase the risks of certain AV malformations (heart problems with the baby), as well as a condition called primary pulmonary hypertenstion (very serious and often fatal). I believe there was about a six fold increase in these risks, when mothers were treated with SSRI's. Keep in mind, that this does not mean that if you are taking SSRI's that your baby will have a birth defect. Even with a six fold increase, the risk for this type of defect was only (approx) 6 in 1000 live births. There are many ways to interpret these studies, so dont go running to the doctor angrily with what I have posted.

The doctors are trained to evaluate the risk and are well aware of the current studies of SSRI's. Keep in mind, that there are many things that can lead to some variability in the rate of birth defects. You might also consider that an uncontrolled (no meds) panic or depressive disorder might be an even bigger statistical risk to your baby than the SSRI's (this is not a statement of fact that I am aware of, just making a point).

Go with a OB/GYN and psychiatrist that you trust and just let them be your guide. If your doctor, doesnt think you should take meds, then you should not. If he does, then you should feel safe that he is evaluating the possible risks.

As far as the question about certain SSRI's being safer, I dont really think that this is true (well it's partialy true). Certain SSRI's like Prozac have a mean half life of approximately 14 days. Other SSRI's like Citalopram have much shorter half lives (approx 10-22 hours according to some studies). Because of this, some doctors prefer to put women of child bearing years on the shorter acting medication. In the event that they become pregnant (or decide to try and have a baby), they can stop taking the medication and have it be out of there system in about a day.

If you were taking one of the other medications (like prozac), there would still be medication in your system long after you quit taking it. This would lead to the developing fetus to have a longer exposure time to the medication and would (in theory) cause a greater risk.

So to sum it up, there are no SSRI's that have been shown to be safer for a developing child. There are some SSRI's however, that are easier to get out of your system if you do become pregnant.

I hope none of this makes any pregnant person on here become worried that she is taking SSRI's. My wife is currently taking an SSRI and I would never suggest that she quite taking it, even if she became pregnant. When she is having uncontrolled anxiety, she spends all day in the bathroom throwing up, looses weight, and cant even eat for days at a time. Whatever small risk that the SSRI poses to the baby would not be as great as the risk posed by a mother who is not eating and unable to provide nutrients to the baby (in my opinion).

So I guess it boils down to your own personal history. If your are dealing with a little minor anxiety/depression/ocd that typically does not affect your day to day life, then I would say that it would not make sense to expose the baby to SSRI's and increase the risk (even if small) of a debilitating birth defect.

If you are, however, like many people who are taking these medications in order to maintain a life that would otherwise be tourment, I would never encourage you to stop taking SSRI's during pregnancy. In my opinion, the harm that uncontrolled (insert your problem here) illness can have on your life, marriage, and relationships, is a greater risk to your baby than the statisticly small risk of birth defect.

[guitarpants]

SSRI's are far more harmful while pregnant than any sort of anxiety. I feel that any doctor that prescribes an SSRI to a pregnant woman should have his license removed.

[craasch210]

SSRI's are far more harmful while pregnant than any sort of anxiety. I feel that any doctor that prescribes an SSRI to a pregnant woman should have his license removed.


I understand your point of view, but I disagree (but only slightly). People often make statements like this because they have read the latest thing that was posted on yahoo, google, etc. If you actualy review the data, the answer is far more unclear than what you read. There are countless numbers of studies showing birth defects increas in relation to various things (smoking, being of a certain race, and even how much money you make). But we must remeber that there is a big difference between two variable being related and causation between those two variables. I mean after all, if I said that there is a correlation that suggest that your baby might have a birth defect because you make less than 100,00 per year, you wouldnt assume that you should make more money to protect your fetus.

I am probably the worlds biggest skeptic of psych medications and believe that overall, they have caused more harm to society than good. I do believe however, that for some people, they are appropriate

[PoppyC]

Hi
Obviously it is your decision, but maybe listen to yourself and your gp than to peoples personal opinions on forums,no matter how well meaning they are, regarding medication. Some people can be very anti medication. If you feel medication would help, than maybe it would be a good thing to talk with your gp.
Your gp is the best person to advise and he/she would not recommend any medication that would harm your baby.
If you feel that the medication would be a help to you, then why not? Why suffer with anxiety and all the rest, when it can be aleviated somewhat?
It must be very tiring when you have anxiety, are pregnant, with a 2 year old to look after. Look after yourself :flowers:
Just to add - I take medication and it has been a life saver for me.
All the best to you.

[Bexmumto3]

I was on Fluoxetine when I fell pregnant with my 3rd child the GP stopped them at around 8wks as he thought it was best but when I saw the midwife & told her she was actually quite angry as she said it was safe for me to take whilst pregnant & that it could cause me more problems by taking me off of them & risking the anxiety/depression becoming worse especially after birth.
Speak to your Midwife/GP and come to a decision between you that suits you & baby best.
Good luck x

[craasch210]

Hi
Obviously it is your decision, but maybe listen to yourself and your gp than to peoples personal opinions on forums,no matter how well meaning they are, regarding medication. Some people can be very anti medication. If you feel medication would help, than maybe it would be a good thing to talk with your gp.
Your gp is the best person to advise and he/she would not recommend any medication that would harm your baby.
If you feel that the medication would be a help to you, then why not? Why suffer with anxiety and all the rest, when it can be aleviated somewhat?
It must be very tiring when you have anxiety, are pregnant, with a 2 year old to look after. Look after yourself :flowers:
Just to add - I take medication and it has been a life saver for me.
All the best to you.


I couldn't agree more. There is no better expert on what is the best thing for you (and your baby) than your own doctor who is familiar with your medical history.

[Momtobe31]

Hey
I have been on sertraline for nearly 4 years. i found out i'm 5 weeks pregnant last week. my pdoc told me to taper the pills in one week but i was scared of the effects on my baby and stopped them cold turkey.
sertraline is in the FDA drug category C. it means it is proven to have bad effects on the animals' fetuses but there is not enough documents about the effect on human fetus. so it is possibly (not definitely) harmful for human fetus. anyway the doctors may prescribe it if they think there is more benefit for mother than the effects on baby.
i personaly did not continue the pills but now having bad symptoms of withdrawal. my doc told me to take Buspirone 5mg instead (which is FDA category B) to cover the symptoms, and taper it in 2 weeks. category B means its proven to be safe in animals, but no studies on human. there is not also any case reports of bad effect on human fetus. so it is probably safe in pregnancy.