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 Post subject: Preparing for trying to get pregnant - medication edition!
PostPosted: Sun Feb 01, 2015 7:40 am 
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Drunk Dialed Ian MacKaye
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I'm at a point in my life where I would like to have children in the new couple of years. I'm on a number of medications and I've made an appointment with my GP, but I'm also trying to educate myself.

I will have to stop most of these medications aside from my thyroid meds, which will be increased, I believe. I'm on Toprol for a rapid heart rate thing, but I have to stop that before trying - that's for sure one that causes problems. The other two are for my mental health - Lexapro and Ritalin. I'm worried about this whole process for obvious reasons and I want to make sure I get the best advice. I do want to have children, but I also want to stay healthy (physically and mentally).

I'm assuming I can't stop these all at once, so I'm thinking the Ritalin will be the first to go. Then the heart pill. And I will need to slowly decrease my lexapro dosage. It seems like this could all take a while.

I'm curious about how your doctors would handle such a case. I think, since I have this heart history, I would be considered a higher risk. What does that mean in terms of how everything plays out? Should I push my GP to send me to a doctor that deals with high risk pregnancy before attempting all of this? I feel a bit lost about the order of everything.

I did stop the BCP a couple months ago and I've had regular cycles since. But it's all the other medicine I am thinking about.

Anyone been on antidepressants and gone off them to get pregnant? How did you manage?


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 Post subject: Re: Preparing for trying to get pregnant - medication editio
PostPosted: Sun Feb 01, 2015 7:56 am 
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Not all psych meds are bad for pregnancy. My psych brought it up in my last appointment with her. The latest is thing to do now is to keep people on their meds as the benefits for both mother and baby outweigh the cons. There is even a possibility of being able to breastfeed on some. I actually sat down and done some research myself after it. I'm on venlafaxine and amitriptyline and would be happy to be pregnant and breastfeed on them. I would prefer to be on just amitriptyline but the side effects I get from it won't make that possible.

I would do plenty of research before making the decision on whether or not to continue anti-depressants while pregnant.

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 Post subject: Re: Preparing for trying to get pregnant - medication editio
PostPosted: Sun Feb 01, 2015 10:37 am 
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i stayed on antidepressants during my pregnancy and am still on them while nursing. i cut my dosage in half which may or may not have been a smart thing.
some antidepressants are considered safe during pregnancy.
i believe zoloft is considered very safe.

most drs now really feel the risk of certain antidepressants that are low risk are much smaller than having a mentally unstable mother. (did i phrase that right? basically it's better to stay on them if you need them for your mental health while you're pregnant rather than wean off them on the slight chance something may happen)


i chose to stay on what i was taking (cymbalta) because i react very badly to weaning on and off meds so i thought it would be stupid to do that while pregnant.
there isnt really any info on cymbalta and pregnancy so maybe it wasn't my smartest choice but there you have it.

do you see a psychiatrist for the mental health ones? they might be the people to talk to about what to take during pregnancy. my OB wasnt very helpful in that regard other htan saying i should stay on something

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 Post subject: Re: Preparing for trying to get pregnant - medication editio
PostPosted: Sun Feb 01, 2015 2:07 pm 
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Drunk Dialed Ian MacKaye
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LisaPunk wrote:
i stayed on antidepressants during my pregnancy and am still on them while nursing. i cut my dosage in half which may or may not have been a smart thing.
some antidepressants are considered safe during pregnancy.
i believe zoloft is considered very safe.

most drs now really feel the risk of certain antidepressants that are low risk are much smaller than having a mentally unstable mother. (did i phrase that right? basically it's better to stay on them if you need them for your mental health while you're pregnant rather than wean off them on the slight chance something may happen)


i chose to stay on what i was taking (cymbalta) because i react very badly to weaning on and off meds so i thought it would be stupid to do that while pregnant.
there isnt really any info on cymbalta and pregnancy so maybe it wasn't my smartest choice but there you have it.

do you see a psychiatrist for the mental health ones? they might be the people to talk to about what to take during pregnancy. my OB wasnt very helpful in that regard other htan saying i should stay on something


My psychiatrist retired and just transferred the management of my meds to my GP. However, he gave me some names of colleagues that I could see if necessary. I see a psychologist weekly and may just talk with her about it next week, too. Maybe she can refer me to a psychiatrist for a one-off convo about the medications.

I'm going to research the lexapro. To be honest, I'm terrified of trying to come off these antidepressants, because they have been crucial to me getting better.

I take it things were okay with your pregnancy and staying on those meds? Forgive me if that's too forward!


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 Post subject: Re: Preparing for trying to get pregnant - medication editio
PostPosted: Sun Feb 01, 2015 2:24 pm 
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Since I've recurrent depression the psych said it would not be advisable I ever come off medication let alone for pregnancy. The risks far outweigh the benefits of going med-free. It would definitely be worth having a conversation with psych if your GP is recommending you come off it.

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 Post subject: Re: Preparing for trying to get pregnant - medication editio
PostPosted: Sun Feb 01, 2015 2:47 pm 
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no worries pickledtreats.
i had the same sort of situation. i had a psychiatrist who was writing the Rx for me but hadnt physically be in their office in years (so no actual therapy just medication consultation). so i did call them and left them a message when i got pregnant and they said if i wanted they could write me a Rx for something different if i wanted but no one really seemed to want to guide me in any sense.

there is a publication (book?) called Medications and Mother's Milk and i believe it is supposed to be the definitive info on at least breastfeeding but i kind think it might cover pregnancy as well. might be a website too.

as far as me and cymbalta and my pregnancy the answer is i dont know.
BabyPunk was born with a congenital heart defect which could have been caused by the meds or it could be 1 of thousands of other things. congenital heart defects are the most common birth defect in babies so it literally could have been anything.
as the mother i will carry that guilt for the rest of my life thinking it was the meds. we were lucky in that it sort of resolved itself.

i did notice one of the times i filled my Rx and actually looked at some of the papers with it that i could call them to be part of some sort of reporting thing on people who have used it during pregnancy and breastfeeding but i have never gotten around to it.

im not saying the above to scare you im just telling you the honest truth. everything in life has a risk and maternal mental health is super important. if i had another bebe i would probably find a different medication and go on that before i got pregnant but i honestly have no idea if the Rx is related. it very well may not have been.

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 Post subject: Re: Preparing for trying to get pregnant - medication editio
PostPosted: Sun Feb 01, 2015 3:14 pm 
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This website might be of some use to start your research.... http://www.ppmis.org.au/index.php/resources_info/australian_categorisation_of_risk_of_medicine_use_in_pregnancy

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 Post subject: Re: Preparing for trying to get pregnant - medication editio
PostPosted: Sun Feb 01, 2015 11:31 pm 
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I took Lexapro (the highest dose, even) throughout my pregnancy and breastfeeding. Like someone said above, my OB said the risks from depression (or anxiety in my case) are higher than the risks from the medicine. My kiddo was fine.

Some things to consider. A significant number of women have new onset depression during pregnancy. You hear about postpartum depression, but depression during pregnancy is pretty common, too. And babies born to mothers with depression are more likely to be preterm and low birth weight and to have heart defects. And you'll be better able to eat well and exercise and sleep and all those other things you're supposed to do if you're taking care of your mental health.


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 Post subject: Re: Preparing for trying to get pregnant - medication editio
PostPosted: Sat Feb 07, 2015 2:31 am 
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I think you should see a psychiatrist about this, since you're on two psych meds. They will have far more experience with these situations than a gp. When I did clinical training in psychiatry, I sat in on a couple of meetings with women who wanted to get pregnant, and they talked about things like trying to plan the pregnancy so the time without meds would be as short as possible. Also, different meds are harmful or not at different stages of pregnancy.

Personal anecdote: I quit taking antidepressants before getting pregnant last time, and had to go back on them (citalopram) when I was about five months along. Like mollyjade says, it's just not great for the baby if you can't eat or sleep. There seemed to be no effects on the baby. Now that we're hoping for another, I switched meds before we started trying to the one my gp recommended, and have no plans to go off it.

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 Post subject: Re: Preparing for trying to get pregnant - medication editio
PostPosted: Sun Feb 08, 2015 6:48 am 
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Drunk Dialed Ian MacKaye
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Thank you all for sharing these stories! My GP sort of looked surprised when I said I wanted to possibly stay on the lexapro, but he didn't say "you have to stop" or anything like that. I'm going to make another appointment with him to discuss pregnancy and my options. I have to increase my thyroid meds anyway and stop this heart pill.

From the quick research I did, it seems most of the issues happened in the third trimester, but as Lisa said, they are defects that can be caused by so many things.

My biggest fear with having children is that I fall into a depression and I don't want to be there. It's bad enough trying to care for myself in that state!


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 Post subject: Re: Preparing for trying to get pregnant - medication editio
PostPosted: Sun Feb 08, 2015 11:33 pm 
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I was really scared of that too. It was comforting to think that I know the signs, so when I start falling now I catch myself early and get help.

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