Pregnancy and SSRI's

[i-square-jere.livejournal.com]

Hey friends!

So my husband and I have had plans for awhile to conceive this fall. He'll be starting graduate school, I'll have a year off until I start my grad program next fall, and we'll have health insurance through school. And we've both wanted kids for a while, and we definitely feel emotionally and financially prepared for a tiny human.

I'm also taking an SSRI, 10 mg Celexa q.d., and I have been for about a year. I remember when I went to get a rx renewal back in February, I mentioned to my doctor that we were interested in getting pregnant before the end of the year. She told me about a recent study that looked at a correlation between SSRI use within a year of delivery and autism, and said that the results were fairly significant. I kind of took it with a grain of salt (because seriously everything causes autism, amirite?), and didn't really find anything conclusive. But it still kind of freaked me out that my doctor was concerned enough to tell me about it.

I'm usually pretty level-headed about things, and am pretty good at deciphering actual statistical data from news extrapolation, but I can't help but worry about this. Also, since neither one of us are in school right now, we don't have access to a journal database, which is kind of what I rely on to see original studies.

So does anyone know anything more about the SSRI/pregnancy/autism connection? How much should I trust my doctor on this? I could get off of my Celexa, but I've worked on tapering off before and it seems like 10 mg is the lowest dose I can take while still keeping my head above water, and I'm hesitant to get off of it completely because I think I owe it to my future progeny to offer them a mentally healthy mom.

Thanks!

Comments

Rambling, Part 2

[archangelbeth]

All of which means... Examine the risks. Do you have a history of ASD (and/or "sure does sound like great-grandfather Joe had it..." stories) in your family, indicating a possible genetic predisposition? Does your partner? Balance whether it might be worth going 3 months (first trimester) on a very low/absent dose or a different medication (I sure can't answer that question! Only YOU can!). Research if there are any other medications that might have less impact, and manage your depression acceptably.

You may want to find an expert in early interventions that can raise functioning (severe autism can be very difficult; moderate to mild points on the spectrum may be "high needs" in some ways, but aren't nearly so stressful), and learn what you can do to ameliorate the negative effects of ASD, appreciate the positive ones, and provide explicit teaching for a kid who might not absorb stuff the way neurotypical ones do. And, for that matter, how to recognize the signs that you might need to do that early intervention.

If you do have a family history of ASD, you may wish to consider if you are in a good place to have a high-needs child. Even with our extremely bright (she got an IQ test when she was diagnosed) kid, there are challenges. We drive our kid to her Social Skills appointments once a week, and it's an hour away. We have an IEP for her at school, and I've had to pull her out of a classroom with a bullying teacher who seemed to think it was okay to shame a kid with delayed-developmental control of her emotions, for crying, when one would hope that teacher wouldn't dare shame a child born without legs for not walking. I have to explain stuff to her that a neurotypical kid would probably pick up instinctively. (On the plus side, she views many unconscious neurotypical assumptions as extremely illogical and to be challenged (she's right...); she's very inclined to follow family rules (if she understands the reasons behind them); she's extremely truthful; and she's amazingly full of empathy for... well, everyone! (As soon as she realizes their point of view, of course; she's a kid, and can be self-centered like any other kid.))

And, again, only Y'ALL can decide if you are in a place where a high-needs kid would be something y'all could manage, and if someone would have unbearable resentment or self-identity issues if it turned out that someone had to be a primary care-giver 24/7 for longer than expected. (And, really, even when there are no risk factors? Sometimes stuff happens. This sort of "weigh the risks, weigh what we can handle, evaluate the extreme ends but don't obsess over them" is... Well, you've probably done some of this at least already, betcha. O:> )

(Again on my biases:

• iahp.org -- Glen Doman's "Teach Your Baby To Read" saved my stability when the kid was much younger. You're only supposed to flash the word-cards for maybe 5-15 seconds at a time, but I remember one night with a fussy baby where I probably did it for a few minutes at a time, with a huge stack of word-cards, because she would sit on my lap and stare in fascination and not fuss! She was reading very early, and considering that she is an attention-demanding extrovert and I'm an introvert... Spoons, I do not have as many as she wants! Books, they entertain her! Still do, too.)

• And thyroid testing! Untreated hypothyroidism has fetal brain damage risks, and I really, really would have liked to have known that my thyroid sucked before I got pregnant, and not years after! I lucked out, BUT! Also, pre-eclampsia stinks.)

Anyway, I hope that I've said everything optimally (... probably not; it's late here... sorry!!), and am wishing you good luck!