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Depression Meds During Pregnancy: Yes Or No?

The decision to take anti-depressants while pregnant is an intensely personal one.

The first thing I did when I found out I was pregnant with my daughter is to stop taking my anti-depressant.

I stopped taking Paxil cold turkey. Not advised. If you’ve ever taken Paxil you know that suddenly stopping sends your system spiraling out of control. And hey, don’t forget about those killer pregnancy side effects otherwise known as morning sickness.

I was a hot mess for two weeks. A sweating, nauseated, mess. In fact, every now and again I’d feel little electric bolts shoot up and down my arms – something the doctor eventually told me was completely normal. The electric bolts really freaked me out and only solidified my decision to stop the meds while pregnant. I mean, did I want my kid ingesting a drug that sent electric bolts through my body when I stopped taking it?

Here’s what I wrote at the time:

Yes, I stopped Paxil cold turkey when I found out. Because I’d been taking it at night in an attempt to avoid the side-effects, most of the withdrawal symptoms are happening during the night. I get so cold I can’t stand it. Raw chicken skin. Although I’m freezing I’m sweating and I have bizarre apocalyptic-style dreams. Serge is worried about my depression coming back while pregnant… we’ll see how it goes. I’ve read many things that state Paxil is fine for pregnant women, that anyone prone to depression is better off taking their meds than not, but I just don’t want my baby (my baby!) ingesting that shiz.

Before those of you who chose to take meds while pregnant get all defensive, let me assure you I am completely behind your decision to do so. I had only been taking Paxil for a few months and did not feel as if taking the drug was worth it. I did a little research and most of what I read about antidepressants and pregnancy was inconclusive. So I stopped. However, I was pregnant at the same time as Heather Armstrong, writer of mega-blog dooce, who famously suffered an intense case of postpartum depression after giving birth to her daughter, Leta. Heather stopped taking her meds during her first pregnancy, which famously led to a complete mental breakdown and landed her in the hospital.  Understandably, the second time around, she decided that her mental well-being was crucial and kept taking her anti-depressants:

Now, on to a burning question that’s sort of sitting out there making a few people uncomfortable or at least a little more curious than they are used to being: I am still taking Prozac. Last year when I found out I was pregnant (the one that ended in miscarriage) we found the phone number for the doctor who treated me for postpartum depression in the hospital in 2004 and left a desperate message. He does not treat anyone outside of the hospital but was generous enough to return our call and answer our questions about medication during pregnancy, and his advice was to remain on Prozac (although he did suggest that I stop taking Neurontin and Valium). Prozac has a half-life so long that even if I had stopped taking it when I found out I was pregnant it would have remained in my system for several weeks. He’s been treating postpartum depression for over 30 years and has seen hundreds of pregnant women who have continued taking Prozac go on to have perfectly healthy babies. My OBGYN agrees with him.

Heather backed up her decision by saying that continuing her meds made her feel so much more prepared, “like I know I’m about to jump into a pond full of crocodiles, and this time instead of throwing in my naked body head first I’m climbing into an armored Humvee that will be slowly lowered into the water, machine guns first.”

I applaud Heather’s willingness to lay it on line like that even though a million people would likely accuse her of trying to kill her baby. I chose to quit Paxil because I’ve always been skeptical about the benefit of anti-depressants for me. Note that I said for me. To others, like Heather, they are a lifeline. Something they require to get out of bed and function daily. Therefore it seems only obvious that she and others like her should continue to take their meds while pregnant. The harm of not taking them far outweighs any documented negative effects of taking anti-depressants while pregnant.

Angela Arsenault over at Mommyish falls somewhere in the middle of Heather and myself. She writes that she consulted her psychiatrist who told her she just didn’t know about the effects of meds on a fetus. “She didn’t feel she had enough knowledge on the subject to provide me with a recommendation either way, so she referred me to a shrink who specialized in reproductive psychiatry.”

That doctor listened to her story and advised her. “If I stopped taking the medicine. She reasoned that the negative effects of depression and a near-constant pounding of stress hormones on a growing baby would be far worse than anything that 100 daily mg’s of Zoloft could do.”

Instinct had been telling me all along that staying on the medication was the right thing to do, but receiving such unequivocal advice from an expert really sealed the deal for me. Actually, I take that back. It was later that same day, while I was sitting on our roof deck and crying out of frustration, wishing that this didn’t need to be a concern of mine. I consciously opened my heart and mind to the wisdom of the Universe and asked for guidance. A few minutes later, there was just one thought at the front of my brain: “Your baby will be okay. Keep yourself healthy.”

I hesitate to write this next part because so many people do require meds, but I also think that Americans are over-medicated. People in the United States take more meds than the citizens of any other country but the numbers are going up all over the world. I once read a doctor’s quote about antidepressants. He said: “There are not enough people taking them for the right reasons and there are too many people taking them for the wrong reasons.”

Now listen, I took them, my husband takes them, I’m not advocating against them. The decision to take antidepressants is an intensely personal one, as is the decision to continue taking them while pregnant. You should talk to your doctor and weigh the pros and cons before making your decision. That’s why I offered you three very different examples of pregnant women grappling with the decision.

I would love to hear your thoughts on the subject. Do you take antidepressants and will you continue to take them while pregnant? Why or why not?

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