Anti Depressants and Pregnancy

[dahrahboomy]

My husband and I are hoping to begin trying to conceive within the next year. I have been taking Paxil CR 25mg for about 5 years for depression and severe mood (anger) swings. My OB/GYN recommended that I wean off of it before becoming pregnant. I had cut down to a 12mg dose every 4-5 days without having physical side effects such as dizziness. However, I am becoming depressed and am having major anger issues. My question is...Are there any anti-anxiety/depression drugs that are generally considered safe during pregnancy? Everyone says "talk to your doctor" but I have only seen my doctor one time and that was for a general check up. At that time she told me that if the weaning didn't work I could switch to Lexapro. However, from what I have read it is not considered safe during pregnancy either so why switch to another drug just to have to get off of it? Also, what other type of doctor could possibly help me?

[mommyof3mpls]

according to the mayo clinic website the only one that has not been linked to birth defects is wellbutrin. I tried that once (between pregnancies) and I couldn't take the nightmares it gave me. unbelievably vivid nightmares. it was crazy. I hear that side effect wears off though, if you can take for a couple of weeks, and the benefits may outweigh that problem for you...

http://www.mayoclinic.com/health/antidepressants/DN00007

[dahrahboomy]

Thanks for the help and the websites. I'm going to go back to taking a 12mg dose every other day. I spoke with my family pharmacist (who often seem to know more about the drugs than the doctors!) and this is what he recommended. As for when I decide to start trying to get pregnant, it seems like I may need to switch to a low-dose of some other type of medicine. Once again thank you for your help and support. This is such a wonderful community, sometimes it's easier to take advice from someone who has actually been through and experienced the same problems rather than doctors who can sometimes only speculate about a condition and how to treat it. A million thanks!

[cutiemama]

I'm pretty sure that there are class action suits against the makers of paxil as it's caused heart defects in babies born to moms taking it while PG. Zoloft is much safer. Speak to an OBGYN or contact motherrisk.org.

[spade22]

I asked my doctor this same question a few months ago and according to her. there are no anti-depressant/anti-anxiety drugs that are considered "safe" during pregnancy.  Most of the "newer"  medications are "Class C" drugs  which means that the drug has been shown to damage the animal fetus but the impact on the human fetus is not known - lexapro, cymbalta, zoloft, and paxil all fit into this catergory.  However, I have recently seen several news items in which paxil has been associated w/ fetal defects so I personally would not take this drug if another Class C drug, which has not been associated with these effects, is available.  

Prozac is a much "safer" antidepressant than paxil.  It has been catagorized as a "Class B" drug which means that while the effect on the human fetus has not been studied adequately, it has not been shown to be harmful to animals.  Here is a link that allows you to acess drug catergories for medications.

http://www.safefetus.com/Search.asp

To answer your second question I would suggest talking to a psychiatrist about your options.  They will be able to suggest the "safest" medication that best suits you and monitor your progress, dosage requirements etc.  They can also go through a risk-benefit analysis with you.

Incidently, I took paxil a few years ago and suffered from bouts of "anger" for a few weeks as I was weaning off the medication - I know of a friend that also experienced the same withdrawal symptom!  My withdrawal symptoms started off mildly and got worse over about 3-4 weeks (anger was an initial withdrawal symptom for me)  and then subsided.  It is important to SLOWLY wean off this medication and can be very dangerous to stop it abruptly.  If side effects are too great from cutting your dosage in half, you may want to discuss a slower tappering program with your doctor (or even better, a psychiatrist).

Good luck to you.

[mayflowers]

Hi, I just read that it's ok to take Paxil during pregnancy.  You might want to keep the dose as low as possible though because they can't be sure that it won't harm the baby.  And by harm, I mean that there is a chance yet there is a chance that you will harm a baby if you take aspirin at the right moment.  

Still, it's better for you to be on something than to go off and have a depressive episode.  Also, don't plan on breast feeding because you will probably want to increase the paxil once you have your baby.

I do think that a gynocologist would be able to help you figure out the best route to take.  They must see alot of women on anti-depressants who become pregnant.  If you are having anger issues, by all means, stay on the paxil.  

Now I haven't been pregnant but I was on anti-depressants for years so I know the  balance that they can bring to ones life.  Good luck to you and your husband!