Prozac during pregnancy?

[Cthycarlson]

I am almost 20 weeks and my dr (psychologist) feels I should go back to taking 20 mg of Prozac (I stopped taking it as soon as I found out I was pg).  I am not doing very well without it. However, I know there still is a divided opinion among professionals about taking SSRIs during pregnancy. I also know a fairly recent study showed an increased risk in breathing problems after birth in women who took SSRIs in the 3rd trimester. My question is, can I take it for the next month or so and then wean off it by 28 weeks and  would this avoid problems?  

[Elaine Brown, MD]

Hi!
You are correct that there are many opinions about the SSRIs and it is very difficult to know what to do!  Most OB doctors feel that they are reasonably safe for use during pregnancy.  Several studies have shown that women who wean off the drug in early pregnancy often have a relapse of symptoms and need to re-start the medication.  Most providers would recommend using the medication at the lowest effective dose.

So, now you have to interpret what I just said!  If you were my patient, I would probably encourage you to re-start at a dosage of 10mg, and increase if that wasn't sufficient.
Once we had re-started, I would probably encourage you to continue to use the medication for the remainder of the pregnancy, and here is why--women who have depressive/anxiety symptoms preceeding pregnancy commonly suffer from at least some degree of postpartum depression, or at least are at high risk.  So, even if my patients have been successful in staying off the medication for the whole pregnancy, I often encourage them to re-start at 36 weeks so that they will be therapeutic during the postpartum period.  (As opposed to crashing and re-starting then).

Each women has to decide what she feels comfortable with.  One other thing to consider, is discussing the issue with the doctor that you plan to use as your pediatrician--as he/she might have some valuable input too!

Good luck!
Dr B

[Thomsop]

Would stop taking it if you can - my friends baby has just come out of special care as it was found that it was high on prozac - (my friend took 2 tablets a day) the baby was jittery and making a funny cry and went from 6lb to 5lb 15oz - apparently it was taking in the prozac from the umbilical cord and through the breast milk once born -  so now she has to wean him off by doing part bottle feed part breast - after 2 days in hospital they are hopefully out this avo - as a mother myself I couldn't take something knowing it would harm my child - but on the other hand I have not suffered from depression and as you are aware pregnancy is an emotional time - its a difficult one - goodluck x