My husband and I are going to try to start having a baby in May. I am currently taking a daily dose of Lexapro, with an occasional dose of Alprazolam as needed for panic attacks. I would really like to wean myself off of the Lexapro during pregnancy. I am one of those people who would blame themselves if their baby was missing an eyelash! One doctor said that it was fine to take Lexapro during pregnancy. (But, duh, such tests couldn’t be conducted on actual pregnant women, I would think?) Another doctor assigned it a certain number that indicated it was fairly safe when taken during pregnancy.
When taking Lexapro, I almost NEVER need an alprazolam. My panic attacks are effectively under control; however, it does happen very rarely that I will need one, in additon to the Lexapro.
My question is…would it be better to continue with the Lexapro and not subject my fetus to a panic attack (not receiving enough oxygen, receiving additional stress.) or to take the Lexapro as recommended without any alprazolam or to take no Lexapro, alprazolam as needed or try to ride it out without any medication?
I’ve done extensive research on this to no avail. For/against are nearly 50-50. I’m really worried about this.
Also, can I pass on a “panic attack” gene? My Mom has had panic attacks, but not nearly to the degree that I have them. Is it even worth it to subject someone to this?
I’m so sorry, but this is really something you’re going to have to decide on your own, of course with the advice of your doctors. Read the manufacturer’s warnings carefully, especially the parts about pregnancy, of course. It contains a lot of information about tests that have been done not on pregnant women, but on pregnant rats. It also contains information about actual human babies born to mothers who have taken Lexapro during the last trimester that I think you should review.
I have an anxiety disorder with a history of panic attacks, but I’ve been able to deal with it without medication. I don’t want to say you should too, or that yours is worse or mine is worse or any of that nonsense. I don’t think suffering is real quantifiable or comparable. I can tell you that my anxiety and panic attacks are far far less when I’m pregnant. Again, that’s just me. It doesn’t mean yours will be any different.
Lexapro is in Category C for pregnancy. Category C means “Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.” That means it has caused harm to rat babies, so no tests will be done on human babies. Generally the decision as to whether or not to continue Category C medications is based on how badly the mother needs it. Obviously, spending 9 months suffering from psychotic breaks is not going to make anyone a good mother. Spending 9 months with mild depression might be worth it. Can you manage 9 months unmedicated? I have no idea.
(The panic attack itself shouldn’t have a whole lot of direct effect on the fetus. Consider how many women give birth to perfectly healthy babies in times of war and considerable stress.)
Basically, every decision you make while pregnant and for the next 18 or more years is going to be a similar crapshoot. You try to investigate and rig the game so the dice roll the way you want, but sooner or later everyone hits craps. You and your partner need to talk and decide what a dealbreaker is for you when it comes to “imperfect” babies. Would the two of you be willing to take a baby on knowing that it would definitely have mental health problems? Assume the worst, and hope for the best, as my grandmother always says.
And yes, like depression, there is apparently a genetic link with anxiety and panic attacks.
I’m sorry, I wish I could make this easy for you and tell you what to do, but no one can do that.
I went off antidepressents when I started trying to get pregnant. Getting pregnant took several years and an adoption.
If I may suggest. If you want to get off the anti-anxiety drugs before pregnancy, wait to get pregnant until you can manage the anxiety drug free. Go see a behavioral therapist, learn biofeedback - whatever is going to work - but don’t get pregnant until you can manage your anxiety non-pregnant (unless you want to say on the meds). Pregnancy is an extremely anxious time. Also, if your anxiety is bad enough, you may want to seriously consider whether having children is best for your health. I wish someone would have really explained to me how nerve wracking and taxing children can be. Have an anxiety attack about losing your job without children - its ten times worse when you imagine your kids out selling matches to buy apples ala Hans Christian Andersen. And kids give you a bunch of new things to have anxiety attacks about. And there is no escaping it…ever. My mother has had one adult child go into rehab and one have a full radical mascetomy in a year.
Well, I have suffered from chronic depression for years, and was on Lexapro when we decided to have a baby. My OB asked me if I thought I need to be on it, and my blunt answer was “yes.” I’m very sensitive to my med levels, and will go into a hole after missing my dose for three days. (I have since switched to Celexa, which is much better for me.)
I’m really glad I stayed on it during my pregnancy, simply due to the horrific things that happend while I was carrying (death of a cat, death of a brother, husband lost his job, my hours got cut, etc.). I honestly think I would have ended up in a psych ward without the Lexapro. I had serious depressive episodes even with it. (Sobbing crying, wishing I’d never gotten pregnant, wishing I would just go away - all that fun stuff.)
Not that I do not believe you but I’d like to see a cite for this. My wife and I are going to start trying to have a baby soon, and I’d like to see the research.
Anecdotal info: My lovely sister has had two wonderfully beautiful children, the boy is 8 and the girl is 5. My sis was on Lexapro for the first and Effexor for the second. He OBGYN told her it was not a problem, she sought a second opinion, and that OBGYN said the same thing. She then went for a tertiary look by a natropath friend of hers…this doc said that she would prefer a holistic approach during pregnancy, but if mom and dad are of good physical health, and there are no compatability issues (RH et al.) then the baby should be fine even with a mom on lexapro…As long as healthy baby has healthy environment, then risk factors for depression and anxiety can be lowered for said infant.
Now mom’s mental wellbeing should be taken care of first and foremost when baby is born, because children and infants can respond to stress in a family.
Hell, from what I hear from the mothers I know, that happens to pretty much every woman in pretty much every pregnancy at least once.
One of my friends had her third recently; two perfectly healthy daughters already, the closest thing to a genetic or birth defect on either side of the family is male pattern baldness… and there were still times when she felt like jumping off the nearest cliff.
Pregnancy is NOT a good time to be going cold turkey on either mood-altering meds or painkillers.
There are studies, fairly recent ones, that show that high stress levels for a mother are harmful to babies in utero. So if the medication does reduce some stress for you, and I find panic attacks very stressful, you may be doing your baby some good by staying on them. However, it is probably impossible to quantify the risks in this situation. Personally, I avoid class C medications when I am pregnant, but I did not take any for depression or panic attacks, so my decision was much easier than yours. Having experienced both when I am not pregnant, I can understand how it would be scary to quit medication which has them under control. Also, medication effects and emotional state can change a great deal during pregnancy.
One thing you can to is see if you can find more about the studies which earned the medication a class C. Sometimes there are clues as to what part of the pregnancy where the drug poses the biggest threat and also to what kind of threat is posed. That might help you to decide what to do.
Also, as you probably know, you should be starting increased folate intake and in general eat right, and by eating right, I mean eating a variety of foods with emphasis on the vegetables. A general rule is less processes is better, and deeper color is better. So, backed potatoes are better than instant mashed potatoes, but baked sweet potatoes are better yet. Do not go on a low fat diet, but rather try to get a balance of fats. Remember your baby’s brain is built on fat.
I found that I dealt with the risks I faced by learning as much as I could about the details. That may or may not work for you. Good luck.
From the Surgeon General’s report on mental health:
Which apparently refers to: Rush, A. J., Stewart, R. S., Garver, D. L., & Waller, D. A. (1998). Neurobiological bases for psychiatric disorders. In R. N. Rosenberb & D. E. Pleasure (Eds.), Comprehensive neurology (2nd ed., pp. 555–603). New York: John Wiley and Sons.
Here’s the link for the section on Anxiety Disorders, which includes panic attacks and panic disorders.
This is me as well, except my sedative is lorazepam.
I’m sorry I can’t offer advice about pregnancy and meds. I will say that my mom was depressive and panicky as a rule but describes her pregnancies as happy times (she was suicidal a lot of the rest of the time).