(( VaginaPagina ))

I'm sorry that I don't know that actual answer to your question, but I just wanted to pop in and remind you that you have to weigh the risks of SSRIs during pregnancy against the risks of unmanaged depression during pregnancy. Some doctors will act like as long as you aren't taking any pills, there is no risk to the baby. Everything has a risk (and your baby needs you).

You would get a ton of responses if you posted this to pregnant.livejournal.com

From:

This is some information about Celexa.

http://www.otispregnancy.org/files/citalopram.pdf

Here's the sheet about depression: http://www.otispregnancy.org/files/depression.pdf

You can also look up other medications: http://www.otispregnancy.org/otis-fact-sheets-s13037

Hope that helps.

Edited Date: 2012-07-20 03:46 am (UTC)

From:

kimie-catclaw.livejournal.com

This. I believe Wellbutrin is the antidepressant of choice for pregnant women (considered the safest) and Zoloft is safest for nursing.

I was encouraged to wean off of Cymbalta before getting pregnant, and fortunately I was able to be okay unmedicated, but if I'd needed something, I wouldn't have hesitated to explore my options with my doctor.

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gryphonwing.livejournal.com

The trick is that Wellbutrin isn't an SSRI or really anything like them - so if your depression responds well to an SSRI there's no real reason to believe switching to WB is a good idea. Might be better than nothing, though, and it's definitely worth a try - it's not as much of a commitment as the SSRI/SNRI types, as you can basically just start at a therapeutic dose and stop it whenever. It's really a different kind of drug.

Another thing to keep in mind, OP, is that for some people pregnancy itself changes the depression picture - emotionally, hormonally. Some people find that depression vanishes during pregnancy (and returns with a vengeance after, yay) and others that it worsens. So it's probably best to have a plan in place about how to best manage depression during and after pregnancy rather than assuming that the same med and dose you're on now will be the best choice then anyway.

You can definitely find a way to manage your depression *and* the risks to your future little one. Lots of people have. :)

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lurkch.livejournal.com

There's also a study showing that SSRIs in water cause autism in fish. It's no fire, but there's certainly smoke:

Antidepressants in water trigger autism genes in fish (http://www.newscientist.com/article/dn21882-antidepressants-in-water-trigger-autism-genes-in-fish.html)

Maybe this is the study your doctor is referencing? Antidepressant use during pregnancy and childhood autism spectrum disorders (PDF file) (http://www.issues4life.org/pdfs/iariskptb034.pdf) (It's actually quite easy to find copies of journal articles listed in Medline for free, just google the journal article in quotation marks and look for a PDF link and if all else fails, email one of the lead authors and politely ask if they would sent you the file--you'd be amazed how often this works.)

Edited Date: 2012-07-20 03:58 am (UTC)

From:

gryphonwing.livejournal.com

Their N is very small and their sampling strategy a bit dodgy, from what I can see; nevertheless, they do seem to have found a correlation between first-trimester SSRI exposure and increased risk of autism. If folks are really concerned I can dig into their stats and methods a little, but the numbers make sense from where I'm sitting. Mostly I'd be concerned about how thoroughly they controlled for spurious factors; their cases weren't a probability sample, so there could well be something there.

Personally, for me, this would mean weaning off my SSRI and trying other tactics for depression control pre-conception, with the intent of adding meds again if I couldn't handle it without them. But that's me, and I know my unmedicated risks.

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As a rule of thumb (and common sense) it is never a good idea to take prescriptions while pregnant. Shit fucking happens. We don't even know what happens to regular humans if they take it a long period of time.

Haven't you seen all the ads for class action suits against big pharm for all the babies born with defects from mental health drugs?

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I strongly disagree with the idea that it is common sense not to treat illnesses with medications while one is pregnant. Illnesses also have effects on the unborn child and people who are pregnant also deserve appropriate medical care. There are risks to everything, and people have to weigh those risks, sure. But rather than just assuming off the bat that all prescriptions should be avoided, we can use evidence-based medicine to compare risks and benefits.

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fortunaestcaeca.livejournal.com

Please don't make such broad statements like "it is never a good idea to take prescriptions while pregnant". Plenty of women take prescription medications (yes, including SSRIs) during pregnancy for all sorts of medical conditions. Besides, this comment is completely dismissing the dangers of untreated depression during pregnancy.

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beckyc.livejournal.com

As a rule of thumb (and common sense) it is never a good idea to take prescriptions while pregnant.

I have to say I disagree with this.

If my specialist tells me I need certain drugs and instructs my GP that I am to continue with that drug on an as-needed basis even during pregnancy, then (assuming I still needed them), it really would not be common sense to stop taking them. Sure, I'd want to minimise the amounts and the number of drugs I'd need, and would carefully consider each one on its own merits, but becoming dangerously ill by not taking much-needed prescription drugs really isn't a sensible thing to do.

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I really don't agree - and I think a lot of those ads are just scare tactics.

In an ideal world, no one would have to take any drugs during pregnancy, ever. Real life doesn't work like that. With mental health issues - and even some physical conditions - you just have to weigh up the pros and cons: I know for me I've decided that staying mentally healthy through pregnancy and early parenthood is worth the very, very slight risk that the medication made affect the baby.

There's no right or wrong answer as to what is right, it is down to each individual to decide for themselves. But saying that taking medication to stay well during pregnancy is showing a lack of common sense... that's unfair.

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Taking medications while pregnant is about a balance of risk and benefit, both to mother and fetus. It think it is incredibly dangerous to say that it is "never a good idea" to take prescriptions while pregnant, because for many women, certain prescriptions have a benefit that outweighs the risk. Prescriptions should ALWAYS be discussed between client and healthcare provider before being discontinued.

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As a healthcare provider, I always find it a bad idea to use prescriptions while pregnant. If someone can't go nine months without taking pills, find another way. The risks of harm to the fetus, to me at least, would be far too great.

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the-bone-doctor.livejournal.com

As a person with multiple disabilities that require medication to live, I strongly disagree with you. It's okay for you to have this belief for yourself, but please do not push it on others. Just because you are a health care provider does not mean that you know anything about this person's unique issues.

For what it's worth, I am on a very high dose of celexa, and my team of doctors agreed that I should stay on my meds if I successfully got pregnant. There are risks and benefits to every single decision anyone makes ever.

From:

Exactly this! My doctor and I have agreed together that when I try for pregnancy I will discontinue my sleeping pills because they are very risky, but I will stay on my anti-depressants and my thyroid medication, because it is important that my depression remains under control. It's still not an ideal situation, but I agree with your last line: every decision we make carries risks and benefits.

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fortunaestcaeca.livejournal.com

Once again, you are being extremely dismissive of the OP's depression (and of anyone who wants to become pregnant and has a medical condition that requires medication). It is simply not realistic for all people to go off medication when they become pregnant. The risks to the fetus MUST be weighed against the risks to the pregnant person (and to the fetus, as well) if the medical condition goes untreated. It is not as simple as "taking medication during pregnancy is bad".

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I was not being dismissive. I was merely expressing ultimate caution.

From:

"If someone can't go nine months without taking pills, find another way."
Can you explain this more? If the person actually can't go nine months without the pills, then what other way would there be?

(The nine month figure is also misleading. Multiply that nine months by the number of pregnancies the person has, and add time trying to conceive and time breastfeeding to that so that you end up with several years in some cases.)

"The risks of harm to the fetus, to me at least, would be far too great."
There are known risks of unmedicated depression. The risks of harm to the fetus, to me at least, would be far too great.

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For you, yes. Being without my medication means that I don't sleep, hear voices, see things that aren't there, get severely depressed, am unable to leave the house, want to self harm and even have suicidal thoughts. As someone with bipolar disorder and a severe anxiety disorder, my medication makes a huge different between stable and unstable - and it is going to be even more vital once I start dealing with pregnancy hormones too.

Now perhaps you think that women like me shouldn't have children - but that's not your call to make. As a healthcare provider, your duty should be what is best for mother and baby.

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People can do what they want - I have to take bipolar meds too and have been since I was a kid. I cannot function without them. As a hermaphrodite, I cannot conceive, and am glad of it. Personally, I don't understand how a person can take meds while pregnant, but I don't say that to pass judgment or dismiss all the different situations that arise. It is just a personal belief.

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*I am glad of it because I will never have to deal with that situation, and that is probably very unique to most, men and women both.

From:

And you are entitled to that belief for yourself, you don't have the right to push it on others or to make other people feel bad because they have chosen a different decision. For me it is a very sensitive issue - I have severe mental health issues, yes, but I want to have my partner's child. I'm prepared to make some sacrifices for that, but I'm not prepared to spend 9 months as a suicidal wreck. What good do you think that would do a fetus?

From:

I have not attempted to make anyone feel bad or be pushy with my own beliefs - you are reading that all on your own.

Like you said about "sensitive issues" - it is for me as well. I am hotly against ANY questionable substances during the duration of a pregnancy. I do understand there are risks and benefits both ways - parent and child. I think if someone wants to be a parent bad enough, they would do whatever it took to ensure a healthy and normally developing fetus. If you think I'm being pushy or trying to ram this belief down others' throats, I am sorry you misconstrued my posts, because that was not my intention.

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Needing medications is not about "not wanting" to be a good parent. Your statement is offensive to me and to the women I see on a daily basis who are working so hard to be healthy during pregnancy (in all of the many definitions of "healthy"!), and I don't think you are containing them to personal beliefs for yourself and any pregnancies you may wish to have when you are providing them as advice to women.

From:

kimie-catclaw.livejournal.com

Always? What about simple infections, like UTIs, that can go bad very quickly? They're easily treated with antibiotics (pills!) which are not harmful to the fetus, whereas an untreated UTI can kill you. It's not like it's a test of wills, not to get a UTI or a sinus infection, or dealing with mental illness, as the OP is.

From:

Or anti-nausea medication that allows women to get enough nutrition for the fetus to grow? Or even the prescribed/ordered medications that HELP the fetus in situations of precarious birth outcomes, like steroids and magnesium in preterm labor?

From:

kimie-catclaw.livejournal.com

Or prenatal vitamins? Heartburn meds? I'd have been miserable without Zantac when I was pregnant, and the heartburn I had was because of my pregnancy. Or people with gestational diabetes that can't be controlled entirely through diet?

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I, too, am a healthcare provider. I stridently disagree with your advice, particularly in situations where mental health is at stake. I think it is dangerous to advise women to stop taking prescription medications on simple merit of their pregnancy. That is a decision that requires full understanding of the risks and benefits, and should be left to the discretion of the healthcare provider and the woman, based on her unique circumstances and personal beliefs. Advising women that all prescription medications are harmful during pregnancy is not only incorrect, but also inappropriate and dangerous.

From:

All good to disagree. And I never meant all prescription drugs, I thought we were focusing on mental health drugs here. Which have been on the market only about 60 years. And we are now just scratching the surface of what they do to people long-term. I work in mental health and see it all the time - most pregnancies by mentally ill women in my care end in miscarriage but the few who do make it to term have babies with a high rate of physical birth defects like encephalitis, missing limbs or clubbed limbs and other physical defects. In short, these women are incapable of parenting due to their illnesses and their bodies are incapable of supporting a pregnancy because of the medicines they need to function as normally as possible.

I absolutely do not mean to say to the OP that she's horrible if she does take her meds or that she shouldn't be a parent if she's someone with a mental illness - but I do mean to say those in such situations are going to have to put a lot more preparation and care and research into such an endeavor as carrying and parenting a child. And again I'll stress that it's kinda personal too - my birth mother (don't know her) used mental health drugs and street drugs in her pregnancy with me and I have three birth defects - webbed toes, Crouzone's syndrome (look it up, pretty interesting stuff actually) and I'm an XY/XO Turner's hermaphrodite. Thank God my brain and IQ are ok!

Basically what I mean when I say that - and talk about my work experience - is a huge red flag goes off along with alarm bells in my head when we're talking psychotropics and pregnancy. In my clinical understanding though, I know a fair and balanced evaluation based on the person's individual needs and circumstances must be conducted.

From:

nightengalesknd.livejournal.com

I am also a health care provider. I also have autism and other disabilities. Life with autism or another disability is not the end of the world for many of us. If I had to make the choice between being alive with autism and a mother who was able to care for me, or alive without autism but with a mother whose untreated depression or other health condition left her unable to provide care, I would choose life with autism without question.

The risk/benefit analysis is one each potential pregnant person must make individually, based on scientific evidence and advice from health care providers and also personal values and beliefs. Different people will feel differently about certain degrees of risk, and also about risk of different conditions assosciated with different medication exposures, and it is my job to give information and support decisions, not to make decisions on behalf of other people.

From:

jocelina.livejournal.com

Hi,

angelcerv25.

We're commenting because your attitude and wording in this comment and in other comments in this discussion thread do not foster what we consider safe space (http://wiki.vaginapagina.com/index.php?title=VaginaPagina_FAQ#Safe_Space) here in the community.

Saying that it's "a rule of thumb (and common sense)" not to take prescription medication while pregnant comes across as judging people who choose to do so; the implication is that, because they are making decisions that you do not approve of and would not make yourself, they lack common sense, and that's not appropriate in this community.

We're concerned about the implied and outright judgment in your other comments. Saying "If someone can't go nine months without taking pills, find another way," and "I think if someone wants to be a parent bad enough, they would do whatever it took to ensure a healthy and normally developing fetus" is inappropriate because it's dismissive and disrespectful of those who have conditions that require medication, as it implies that their legitimate medical need is a careless or imprudent choice and evidence that they don't "want to be a parent bad enough."

Similarly, saying things like "In short, these women are incapable of parenting due to their illnesses and their bodies are incapable of supporting a pregnancy because of the medicines they need to function as normally as possible," makes some sweeping, negative generalizations not only about the ability of those with mental illness to be parents, but also about the quality of their lives as compared to neurotypical people.

We're also concerned that your statement in this comment (http://vaginapagina.livejournal.com/21032796.html?thread=245212764#t245212764) that you're thankful that your "brain and IQ are okay," may be deeply upsetting and offensive to those with developmental disabilities -- while the way they function may be different, it doesn't mean that they're not okay, or that neurotypical/nondisabled people have the right to make such comments.

Finally, we want to point out our policy on misinformation (http://wiki.vaginapagina.com/index.php?title=VaginaPagina_FAQ#What_is_misinformation_and_why_does_it_matter_in_VP.3F), specifically as it applies to sharing personal experiences. While we appreciate that the information you have shared here is your personal experience, you've couched it in such terms that a reader might take it to mean that the majority of people who use psychiatric drugs in pregnancy experience the type of adverse outcomes you describe. This is an unsourced and unsupported claim that is not backed up by current medical research.

We appreciate that you acknowledge here (http://vaginapagina.livejournal.com/21032796.html?thread=245212764#t245212764) that such decisions are best reached via individual evaluation (with professional support), but we feel that your other comments and claims in this thread fail to take this into account.

If you'd like more information on safe space (http://wiki.vaginapagina.com/index.php?title=VaginaPagina_FAQ#Safe_Space), please refer to these items in our FAQ (http://wiki.vaginapagina.com/index.php?title=VaginaPagina_FAQ):

--What are VP's rules? (http://wiki.vaginapagina.com/index.php?title=VaginaPagina_FAQ#What_are_the_rules.3F)
--What is "safe space"? What does "empowerment" mean? What does "accountability" look like? (http://wiki.vaginapagina.com/index.php?title=VaginaPagina_FAQ#Safe_Space)

You are more than welcome to make a post over in

contact_vp or to contact us via email (http://www.vaginapagina.com/contact.php) If you'd like to talk more about this matter or clarify any points; we only ask that you refrain from commenting further here out of respect for the OP. For that reason, replies to this thread will be frozen.

Jocey
for the VP Team (http://www.vaginapagina.com/contact.php)

contact_vp

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