Antidepressants While Pregnant–Follow Up

Fi and me on beach

It was so reassuring to know I’m not alone in my conflict of staying on meds while pregnant. And even though I know I’m making the right decision for myself, I do worry at times. How could I not? Someone who read my blog recommended a Reproductive Psychiatrist at NYU. This is an extremely specialized department on the cutting edge of research.

I saw the psychiatrist this week and I wanted to pass along what she told me. Knowledge is power, right? I’m going to take another leap here and even include the actual meds and dosages I’m on. Here goes:

At conception, if you’re taking antidepressants, then the baby is exposed. As she put it, “Exposure is exposure.” Meaning, going off at 3, 6, 9 months etc. is not going to make a difference. It’s the first couple months that are the big development stages.

I asked her about the studies that say there’s a 1-2% chance of cardiovascular/pulmonary issues in your baby if you take an SSRI (like Lexapro, Zoloft, Prozac, etc.). She said there is no conclusive evidence that those drugs cause higher risk under certain dosages. For example, the recommended maximum dosage for Lexapro while pregnant is 20-milligrams. (I’m currently on 5 mg, which I went down to on about the 3rd month of my pregnancy). She explained that those same risk percentages (1-2%) exist in the general population of pregnant women. Factors such as age, smoking, diet, etc can potentially elevate those risks. But not necessarily SSRI’s taken at the recommended dosages.

She also said to stay the course with what works mentally. You want to avoid huge ups and downs and being a human yoyo. It is better for you, but more importantly—the baby.

I’m also on Wellbutrin. The studies show there are no known or proven higher risks when taking while pregnant at the recommended maximum dosage. It is 300 milligrams or less on the extended release tablets. I’m on 150 milligrams.

Having said all this, studies have shown that the more drugs you’re on, the greater risk for some sort of issue/problem. That kind of follows logic, right? If she had met me before I got pregnant, she probably would have increased my Lexapro and taken me off Wellbutrin entirely. That way, I’d only be on one drug. But she assured me it’s really nothing to be concerned about. She’s had women with far more complicated drug combos than mine who have had beautiful babies.

When it comes to breastfeeding, the risks go down even more. The breasts act as a secondary filter (the body/blood being the first filter). She said tests were done with breastfeeding moms at a 20 mg dose of Lexapro and 300 mg of Wellbutrin. Those tests showed zero trace of the drugs in the baby.

And finally, bottom line: healthy, happy, anxiety-free mom = chances for the best baby. All the evidence supports that.

I thought this was some great information to have. If any of you have other information, I’d love to hear it.

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  1. by HollyEllis

    On August 27, 2011 at 3:39 pm

    Thank you SO much for this! I’m currently TTC and take 5 mg of Lexapro a day. I was terrified of what it might do to my baby. Thank you for reassuring me that all will be well and that its not selfish of me to want to stay on the medicine! :)

  2. by Sarah

    On August 28, 2011 at 3:35 pm

    I feel blessed to have come across your blog today. Like you said, and I had to smile, not a lot of good comes from hours of googling and reading every conflicting article and post out there. For every 10 bits you read where someone says it’s safe, you find 1 that says “it might not be safe,” and it’s so hard to not focus on that small possibility that you could be “selfishly” putting your baby at risk. After an hour or so of this “research,” my husband came home to find me sniffling, curled up in a little ball of despair, convinced that I had to choose between me or my baby, and how dare I have a baby at all, if I’m so scared to go off of my meds!? …This cannot be healthy.
    I have a strong family history of depression, and when mine came along almost 10 years ago, I began therapy and 100mg of Zoloft. For the last 8 years I have been just as happy and symptom-free as I could be, on 150mg. I know that this is genetic for me and there isn’t much getting around it.
    Today is the last day of my devilish “two-week wait,” and I’ve been so excited to become pregnant. I had almost forgotten that I live on a medication that may or may not cause my baby to have all kinds of problems. I became racked with guilt. I have an appointment with my doctor tomorrow and she just might confirm that I am pregnant. I am very anxious to hear what she will say; will she think that I’m irresponsible for becoming pregnant when I’m not healthy enough to ensure a healthy baby?
    My husband says that there are so many risks that you take when you get pregnant, and so many of them are beyond our control; the most important thing is that I prioritize my own health. I know that I cannot be a healthy mom if I cannot eat or move or think straight. But if my child were born with a defect because of a choice that I made, how could I live with that?
    I plan to discuss all of this with my doctor tomorrow, and I pray that she will be compassionate and non-judgmental.

    Anyway, you are my hero for today, Jill, because I am now going to go take a walk, read a book, and call a friend. Anything but more googling!!! I needed your words today, and I thank you, and wish you all the luck in the world!

  3. by jill cordes

    On August 30, 2011 at 11:49 am

    Sarah, I’m so glad I could help. Makes me feel purposeful on this big earth. Enjoy your time with the pregnancy. That is most important. And remember, happy mom=happy incubating baby. That is the most crucial piece of information I got. And 150 mg zoloft is a fine level, according to the specialist I went to (I had asked her about that, as I used to be on it).

    Went for my 18 week ultrasound yesterday and all was a-okay. No holes in heart, etc etc. You will be great!

    And same to you Holly. Enjoy the pregnancy! Jill

  4. by Kim

    On September 26, 2011 at 11:37 am

    I personally didn’t take the risk and went off all medication for my pregnancy with my son and I am currently pregnant (6 months) and did the same during this pregnancy.

    It wasn’t just the statistic that bothered me, it was the fact that this child wouldn’t have prolonged exposure to a medication. I don’t agree with that exposure is exposure because well…taking something when you got pregnant (a few weeks in) and taking something for 9 months while the child is developing inside you are not the same levels of exposure.

    Do I think that it is going to cause absolute harm to the baby? I don’t know, and there doesn’t seem to be firm proof going either which way, it was more of a personal choice not to continue on my medication while pregnant. I was taking Xanax when needed and I believe it was Zoloft, and while it has been hard at times, I know for me, I’m doing the right thing.

    It kinda goes along the same lines as Mom’s justifying their glass of wine during their final months, its a personal choice. I choose not to take it, but to each their own.

    I’m sure that it may have been a lot easier staying on medication, and I aplaud you for telling your story. I’m sure there are women out there who don’t know how to cope without taking their medication. While it was not easy taking myself off of my medication, I hope this helps Mom’s out there to understand that you are not evil if you choose to continue to take your medication. Mental health is so important and in my opionion, highly looked over when thinking about how to take care of yourself while pregnant.

  5. by Lorelei

    On September 26, 2011 at 6:43 pm

    This makes me feel better. I suffer from depression and I’m on celexa and welbutrin. If I’m off of them, it is not a pretty sight! So, thank you so much for writing this. =)

  6. by mya

    On October 14, 2011 at 4:15 pm

    I am a lawyer who handles mass torts. Recent medical research shows that taking Zoloft (or other SSRI’s) during pregnancy is linked to autism. Originally, research did not find the connection, but we now have evidence of the link. I am very sensitive to this issue because it has impacted my family. I am only trying to spread the word so people can protect their rights and the rights of their children. You can go to chadpinkerton.com for more information or contact me at 1-855-ZOLOFT-1. If this is out of line, I apologize in advance. My intention is only to help. And, I can help.

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