Dear Susanne
I am sorry I did not get back to you on this yesterday - I needed to do some research on this as I am usually asked about medication and breastfeeding as most women on here take Medication after the birth, so this was new.
But I do know two women on here who have taken SSRIs while pregnant on the advice of their doctors.
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Please note*
I am not medically qualified - I am only passing on the 'opinion' of any medically trained people I may ask ( and these are not giving their opinion on here officially - so theirs is an opinion also)
and I am also summarizing the research and medical conclusions I have read and I will point you to anything I found on line so you can read it to and draw your own conclusions.
However I am only doing this to point you in the right direction for a 'lay persons' answer to the question you asked and nothing I say can be or should be regarded as more than an opinion and you should of course consult your Doctor! As of course you are about to do.*************************************************
I asked a doctor and a nurse and looked it up and it seems that there is no conclusive evidence either way that anti Ds have any effect on the fetus ( of course it Depends on what ones so here I am talking about SSRIs ( Prozac which is fluoxetine, citalopram , paroxetine, escitalopram ) and Tricyclics (Trycyclics are an older type –which are often given in breastfeeding as they have been used for so many years with no ill effect to breastfed babies)
If anything the evidence that has been gained by experience and research ( most research has been done in the US) does in fact point to their being no worrying effects on the fetus or the baby after birth - although their have been reports of babies being born with quite high levels of SSRIs ( but only in one bit of research I could find that has not been confirmed) and having some mild withdrawal.
So the answer is that no one is yet certain although their have been more evidence that these Anti Ds are OK not enough has been done to prove this so no one is going to stick their neck out and say that these Anti Ds in pregnancy are totally safe to the baby. see these Internet reports:
www.kidsource.com/pregnancy/preg.antidepressants.htmlThe report below on research is less positive on pregnancy but more positive on breastfeeding - but still gives no conclusive reason not to prescribe Anti Ds in pregnancy if it is necessary:
www.dr-bob.org/tips/split/Antidep-preg-lactation.htmlThe following report shows that in the US at least pregnant women are advised not to come off Anti Ds:
www.psycport.com/stories/canadianp_eng_2005_05_23_eng-canadianp_health_eng-canadianp_health_233902_371038369042160777.xml.htmlThis is a guide to Guide for Patients and Families on this subject:
www.psychguides.com/DinW%20during%20pregnancy.pdfThe conclusion seems to be (and confirmed by the doctor I asked) is that their is no conclusive evidence that babies are adversely or permanently affected by their mums taking Ant Ds in pregnancy.
Of course it is always safer not to take anything so whether they are prescribed is down to the individual doctor the patient and the perceived risk to the mother if she does not take medication for depression while pregnant.
A quote from Dr. Gideon Koren, director of Motherisk :
"Like everything in medicine, you have to strike a risk/benefit balance. And what we know about the baby now is that the risk is very small. We know that many of the women may have a huge risk."
I guess only you can really know how you are coping without them and if you feel that you do need to take medication then I should go back to your advisers and doctors and ask for Anti Ds while pregnant.
Also it says about most SSRI's on Medicine Net:
www.medicinenet.com/escitalopram/article.htmPREGNANCY: The safety of escitalopram ( same for during pregnancy and lactation has not been established. Therefore, escitalopram should not be used during pregnancy unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the fetus.
which is more positive than what is said for other SSRIs as for most others it says:
' There are no adequate studies of fluvoxamine/citalopram /paroxetine/in pregnant women.'
or
'Sertraline's safety in pregnancy has not been established'
I do not know if this is because more research has been done on escitalopram than any other SSRIs - I doubt it , it was probably just written by a different doctor!
Common understanding would suggest that if you can wait until the 2nd trimester before taking them this will put your mind at rest about any medication causing malformation ( although their is no evidence of this) as the baby will by then be fully formed.
Personally from what I have read I think that if you feel you need them - given your previous history of depression - then I would see no reason not to go to your doctor and ask if you can go back on them?
All the best
Veritee
