# Antidepressants, babies, decisions **URL:** \ **Category:** In My Humble Opinion\ **Created:** [January 13, 2012, 11:10pm UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448 "2012-01-13T23:10:31Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Antigen](https://avatars.discourse-cdn.com/v4/letter/a/848f3c/32.png) [@Antigen](https://boards.straightdope.com/u/Antigen)\ **Post date:** [January 13, 2012, 11:10pm UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/1 "2012-01-13T23:10:31Z")
I stopped taking my Wellbutrin six months ago when we started trying to conceive, because everything I could find about Wellbutrin and pregnancy said “we’re not sure if it’s bad, so you should probably stop just in case”. I was OK for a while, and I was thinking I could get by fine without it thanks to all the wonderful CBT skills I picked up with my therapist, but by now I’m feeling the pain. Maybe it’s a seasonal thing, but whatever it is, I’m slowly slipping back to where I was before - frustrated, lonely, unable to focus - and it’s worrying me. I don’t know what to do. Yes, “talk to your doctor” will probably be the first suggestion, and I know that’s what I should do, but it’s not as easy as that. My family doctor is my aunt, and I don’t feel comfortable telling her we’re trying for a baby, because I’m nervous her “medical professional” side might be overpowered by her “excited aunt” side, and I really don’t want anyone in my family to know yet. That’s probably unfair of me, to worry about her professionalism, but even if she absolutely wouldn’t say a thing, I have that worry in my head, making it hard for me to open up and tell her. I can talk to her about my symptoms and she will probably recommend starting back up on the low dose again, but I really need more information and opinions. I guess I’ll have to find another doctor to ask about this, but the OB/GYN office I would like to be using once I’m pregnant has a 4 month waiting list if your visit is not pregnancy-related. I don’t want to put everything on hold, and I don’t think I can handle 4 months like this anyway. I want to make myself healthy and functional, and I don’t want to hurt my chances at conceiving and having a healthy baby. I’m afraid that those two may be mutually exclusive, and I don’t know which needs to come first. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [January 13, 2012, 11:22pm UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/2 "2012-01-13T23:22:25Z")
Why the heck is your doctor also your aunt? It’s not generally considered medically ethical for a physician to treat family anyway, save in urgent or emergent situations, to prevent exactly the sort of situation you describe. Get your own doctor who’s not a relative or friend or otherwise involved in your life. And ask the doctor you want to have if they can refer you to someone who is taking patients now. You’d benefit from counselling and direction now, not in 4 months. Good luck! ---
**Author:** ![missinformation](https://avatars.discourse-cdn.com/v4/letter/m/d07c76/32.png) [@missinformation](https://boards.straightdope.com/u/missinformation)\ **Post date:** [January 14, 2012, 12:03am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/3 "2012-01-14T00:03:33Z")
When you find another doctor, also find out about a high-risk obstetrician. Explain to new doctor and also your therapist that you are trying to conceive and that you would like to know about antidepressants that would not harm the fetus. I worked for a psychiatrist who referred a client to a high risk obstetrician. Client was on anti-depressants and saw the psychiatrist once monthly and the obstetrician more. The baby was perfectly healthy and gorgeous (ok, a bit biased…got to see her every appointment! :)) Good luck to you. ---
**Author:** ![Idle\_Thoughts](https://avatars.discourse-cdn.com/v4/letter/i/838e76/32.png) [@Idle\_Thoughts](https://boards.straightdope.com/u/Idle_Thoughts)\ **Post date:** [January 14, 2012, 12:13am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/4 "2012-01-14T00:13:20Z")
Hope it all works out for you. Moving to IMHO. ---
**Author:** ![FlyByNight512](https://avatars.discourse-cdn.com/v4/letter/f/82dd89/32.png) [@FlyByNight512](https://boards.straightdope.com/u/FlyByNight512)\ **Post date:** [January 14, 2012, 12:43am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/5 "2012-01-14T00:43:21Z")
As one point of anecdata, my doctor has told me that antidepressants during pregnancy are not nearly the problem they get made out to be. An O/B or Psychiatrist (preferably one who’s done this before) may have a very different take on it than what you’ve read about online. Your local Planned Parenthood branch may be able to point you in the right direction if you’re having trouble finding one. Good luck! It really, really sucks to need antidepressants and not have them. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [January 14, 2012, 12:50am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/6 "2012-01-14T00:50:02Z")
I am _in no way_ giving you medical advice; I am merely pointing you to a relevant article. According to that article, untreated depression during pregnancy is a significant [risk to](http://womens-health.jwatch.org/cgi/content/full/2007/426/1) the developing fetus; antidepressants not so much so. > [@](#): > > Despite the cautionary remarks commonly made by most regulatory agencies and medical societies about the use of psychotropic medications during pregnancy, considerable data supporting the efficacy and reproductive safety of antidepressants have accrued.5 Conversely, evidence suggests that untreated depression has negative consequences for both mother and child. Depression during late pregnancy is associated with poor obstetric and neonatal outcomes, including increased risks for cesarean and instrumental vaginal deliveries, intrauterine growth retardation, and premature delivery.6,7 The impact of untreated depression during pregnancy is not limited to perinatal adverse outcomes. The authors of a prospective study of mother–child pairs suggested that uncontrolled maternal depression during and after pregnancy might adversely affect the child’s IQ and language development and showed that such adverse effects were not associated with the use of antidepressants … > > … Which antidepressant agents are safest and most efficacious for use during pregnancy is a commonly asked question. A recent meta-analysis included seven prospective studies of the teratogenic risks associated with first-trimester exposures to antidepressants that have entered the market since 1980 (such as selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors). The incidence of malformations in infants exposed prenatally to fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), venlafaxine (Effexor), nefazodone (Serzone), trazodone (Desyrel), or bupropion (Wellbutrin) was compared to that of nonexposed infants. The composite sample size (n = 1774) was sufficient to rule out any increased risk for major malformations with prenatal exposure to these antidepressants as a group compared to the baseline rate of 1% to 3% found in the general population.5 … > > … Because available data are insufficient to support a clinical recommendation as to which SSRI is the safest to use during pregnancy, switching from an ongoing, successful treatment to a different antidepressant is generally not recommended — particularly when the clinical response of the patient to the alternative medication is unknown. … > > … In summary, clinicians should bear in mind the mounting evidence about the adverse effects of uncontrolled depression during pregnancy. However, decisions about management must be individualized … It appears that you have, on the one hand, no documented risk of harm (treating the depression), and on the other hand documented risk of harm to both mother and child (and rest of family too), from untreated depression. And yes, get a doctor who can be your doctor and not your aunt. ---
**Author:** ![Antigen](https://avatars.discourse-cdn.com/v4/letter/a/848f3c/32.png) [@Antigen](https://boards.straightdope.com/u/Antigen)\ **Post date:** [January 14, 2012, 12:52am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/7 "2012-01-14T00:52:33Z")
> [@Qadgop\_the\_Mercotan](#): > > Why the heck is your doctor also your aunt? It’s not generally considered medically ethical for a physician to treat family anyway, save in urgent or emergent situations, to prevent exactly the sort of situation you describe. I know, I know. No excuse for it, really, other than convenience and the fact that she doesn’t charge me for a visit. I’ve got an appointment with my therapist in a few weeks, and there’s someone there (a PA, I think, along with a psychiatrist) who deals with the medication side of mental health, so I can ask for an appointment with one of them too, but I don’t know if this is a question for a doctor who deals with mental health issues or one who deals with pregnant women. Who knows best? It will likely be easier and quicker to get an appointment with someone at my therapist’s office, so I guess I’ll start there by calling on Monday. And I’ll look for a go-to-when-sick “regular” doctor, too. **missinformation** - high risk? Why? I’m not sure I understand. ---
**Author:** ![EmAnJ](https://avatars.discourse-cdn.com/v4/letter/e/d2c977/32.png) [@EmAnJ](https://boards.straightdope.com/u/EmAnJ)\ **Post date:** [January 14, 2012, 1:42am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/8 "2012-01-14T01:42:55Z")
I’m on Prozac and also TTC. My doctor chose Prozac specifically because we are trying right now and it’s considered the ‘safest’. When I was worried about the effects, she said that the benefits of being on the antidepressant outweigh the risks to the fetus for most people. No telling what pregnancy hormones will do to your moods, so best try to regulate them if you can do so with minimum risk. ETA: My therapist also supported the doctor’s decision to use Prozac. ---
**Author:** ![Nymysys](https://avatars.discourse-cdn.com/v4/letter/n/f6c823/32.png) [@Nymysys](https://boards.straightdope.com/u/Nymysys)\ **Post date:** [January 14, 2012, 2:05am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/9 "2012-01-14T02:05:50Z")
I take Buproprion (300mg XL once/day) as well. It was the first thing discussed with my OB/GYN when removing my IUD in preparation for conception. She also said that the risk of being non-functional far outweighed the theoretical, unknown risk to my fetus. I’m 38 weeks pregnant, and everything, including the amnio and 3D sono results, is perfect. I even enjoyed my pregnancy, at least up until this last week or two. 🙂 We’ve also met with our impending pediatrician to discuss Wellbutrin use during breastfeeding. He also echoed the sentiment of “We don’t know for sure, please take care of yourself first.” and fully supports my continued use. YMMV, of course, but my husband compared it to the oxygen masks on an airplane. You’ve gotta make sure you are functional before you can confidently take care of your child. I wish you luck, and I concur you need a new, non-related care provider. ---
**Author:** ![1GothMama](https://avatars.discourse-cdn.com/v4/letter/1/90ced4/32.png) [@1GothMama](https://boards.straightdope.com/u/1GothMama)\ **Post date:** [January 14, 2012, 2:43am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/10 "2012-01-14T02:43:36Z")
Not much to add, though I agree you need a doctor who’s not family. I just wanted to mention that I read an interesting article in . . . Parenting, I think, a few months back talking about antidepressants during pregnancy. The common thought now seems to be that approved antidepressants are far less harmful to the fetus/baby then the hormones you produce when feeling depressed. So it’s really in your and the future baby’s interest to find a medicine you can be on while incubating. Good luck in both the trying to conceive and the medication finding. ---
**Author:** ![FlyByNight512](https://avatars.discourse-cdn.com/v4/letter/f/82dd89/32.png) [@FlyByNight512](https://boards.straightdope.com/u/FlyByNight512)\ **Post date:** [January 14, 2012, 2:58am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/11 "2012-01-14T02:58:29Z")
> [@Antigen](#): > > **missinformation** - high risk? Why? I’m not sure I understand. “High risk” tends to mean “anything out of the ordinary”. An OB who specializes in high risk pregnancies will probably have more experience with the interaction of antidepressants and pregnancy than a ‘normal’ OB would. ---
**Author:** ![Avarie537](https://avatars.discourse-cdn.com/v4/letter/a/48db29/32.png) [@Avarie537](https://boards.straightdope.com/u/Avarie537)\ **Post date:** [January 14, 2012, 9:07pm UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/12 "2012-01-14T21:07:44Z")
My OB was perfectly OK with my continuing to take my antidepressants while pregnant and nursing. ---
**Author:** ![corvidae](https://avatars.discourse-cdn.com/v4/letter/c/898d66/32.png) [@corvidae](https://boards.straightdope.com/u/corvidae)\ **Post date:** [January 15, 2012, 3:07am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/13 "2012-01-15T03:07:33Z")
I don’t know if this will help, but you might want to check out [Motherisk](http://www.motherisk.org). There is a lot of drug info on the site about what you can and can’t take while pregnant or nursing, and you can call the helpline for whatever isn’t covered. ---
**Author:** ![Neeps](https://avatars.discourse-cdn.com/v4/letter/n/a183cd/32.png) [@Neeps](https://boards.straightdope.com/u/Neeps)\ **Post date:** [January 16, 2012, 9:08pm UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/14 "2012-01-16T21:08:06Z")
Again, nothing but a personal anecdote, but my doctor, and my consultant at the fertility clinic, were both happy for me to continue taking venlafaxine whilst ttc, and whilst going though an IVF cycle. I’m now 8 weeks pregnant and am going back to talk to the doctor in a few days about perhaps reducing my dosage, but to me, the risk of stopping completely is probably not worth taking. I am taking it for anxiety, rather than depression, but my doctor agreed that treating the anxiety was a priority at the moment. Could you find another doctor, and then maybe try something like Prozac, that is considered ‘safer’ (like \*\*EmAnJ \*\*is doing)? ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [January 16, 2012, 10:53pm UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/15 "2012-01-16T22:53:45Z")
> [@EmAnJ](#): > > I’m on Prozac and also TTC. My doctor chose Prozac specifically because we are trying right now and it’s considered the ‘safest’. When I was worried about the effects, she said that the benefits of being on the antidepressant outweigh the risks to the fetus for most people. No telling what pregnancy hormones will do to your moods, so best try to regulate them if you can do so with minimum risk. > > ETA: My therapist also supported the doctor’s decision to use Prozac. Anecdote != data but a friend of mine was also on Prozac while pregnant and the baby was fine (delivered prematurely, but that was completely unrelated to the Prozac use). Now, I do see ambulance-chaser ads saying that Paxil causes problems, but I have zero idea of how much of a problem that really is. Thirding / fourthing etc. the suggestion that you see a doctor who is _not_ your relative. Does your aunt do your regular gyn stuff? If not, go to your gyn and ask his/her opinion - you won’t be the first patient they’ve seen in that situation. ---
**Author:** ![TokyoBayer](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tokyobayer/32/13989_2.png) [@TokyoBayer](https://boards.straightdope.com/u/TokyoBayer)\ **Post date:** [January 17, 2012, 2:48am UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/16 "2012-01-17T02:48:52Z")
> [@Antigen](#): > > Maybe it’s a seasonal thing, but whatever it is, I’m slowly slipping back to where I was before - frustrated, lonely, unable to focus - and it’s worrying me. I don’t know what to do. I’ve told my wife that if I decide to go off my antidepressant, that these signs are things which she should watch for, because they happen to me when I’m off my medication _and_ something stressful comes along. ---
**Author:** ![RoniaBorkason](https://avatars.discourse-cdn.com/v4/letter/r/9dc877/32.png) [@RoniaBorkason](https://boards.straightdope.com/u/RoniaBorkason)\ **Post date:** [January 17, 2012, 5:03pm UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/17 "2012-01-17T17:03:16Z")
Anecdotally, I was on generic Prozac while I was pregnant in 2010, and had no serious adverse effects - I delivered early full-term, 37 weeks 4 days, and while my son was born purple ( a known side-effect), he pinked right up and was fine, just purple. I’ve continued the Prozac through breastfeeding also, no problem. ---
**Author:** ![Lissla\_Lissar](https://avatars.discourse-cdn.com/v4/letter/l/8491ac/32.png) [@Lissla\_Lissar](https://boards.straightdope.com/u/Lissla_Lissar)\ **Post date:** [January 17, 2012, 5:51pm UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/18 "2012-01-17T17:51:45Z")
Sorry, off topic. **Neeps**! You’re pregnant again! How’s the morning sickness this time round? I’m 32 weeks with the twins right now and I just threw up this morning. /Back to topic. ---
**Author:** ![Nymysys](https://avatars.discourse-cdn.com/v4/letter/n/f6c823/32.png) [@Nymysys](https://boards.straightdope.com/u/Nymysys)\ **Post date:** [January 17, 2012, 7:38pm UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/19 "2012-01-17T19:38:55Z")
As an addendum to my previous anecdote, I delivered on Saturday at exactly 38 weeks (expected due to my SUA) a perfect baby boy, 7lbs 7oz, 20 1/2 inches. ---
**Author:** ![Maastricht](https://avatars.discourse-cdn.com/v4/letter/m/a88e57/32.png) [@Maastricht](https://boards.straightdope.com/u/Maastricht)\ **Post date:** [January 17, 2012, 8:33pm UTC](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448/20 "2012-01-17T20:33:38Z")
> [@Avarie537](#): > > My OB was perfectly OK with my continuing to take my antidepressants while pregnant and nursing. Antidepressants can turn up in mothers milk, so ask your doc advice about the risk/benefits of nursing while on AD. Also, it may last longer then you expect now. My attempts at pregnancy initially failed, and in the end, with nursing and everything, I was off meds for two and a half years. I think I missed out on enjoying pregnancy and my baby as much as I could have. [Next page](https://boards.straightdope.com/t/antidepressants-babies-decisions/609448.md?page=2)