I am getting increasingly concerned with this.
I had moderate antenatal/postnatal depression and OCD with my second son. I have been on antidepressants since he was born. Now pregnant with my third, I have already made the decision that I want to come off the drugs by 20 weeks and went to GP to begin taper as soon as I realised I had fallen pregnant. She agreed to support my decision and monitor but also told me sertraline was 'totally safe'.
My decision is based on my personal risks and NICE guidelines.. NICE suggests this is the way forward and supports a switch to psychotherapy for women with my profile.. The risks of untreated depression in pregnancy are low birth weight, prematurity, complicated labour, pnd and some discussion about longer-term delayed development in the baby. I was quite unwell with my son and opted for no medication and he was born at term plus nine at 9lbs in a straightforward waterbirth and all developmental milestones have always been on time. I always ate well and attended all appointments. I was never suicidal or psychotic etc. I am currently well and receiving CBT and doing Mindfulness meditation.
As my previous GP left I went to explain this to the new one. Two minutes into the consultation she said that it was 'safer' to stay on the drugs and there were no risks. She was not happy to reduce my dose further though I had no side effects from taper. Obstetric consultant said, to his credit, not enough data but then went on to say there were no data to suggest there were any risks with my drug, sertraline and 'no need' to monitor a baby after birth despite most research saying observation is needed as 15 to 30% will develop neonatal abstinence syndrome.
I have been referred to the specialist perinatal mh team again but won't be seen until 18 weeks pg at least. Saw them last time and they offered nothing but medication.
This just feels shoddy to me. There are risks. Small but serious risks including a serious and potentially life threatening lung condition in the newborn.
Where is the information about psychotherapy here, where is the guided self-help resources or information on promising alternatives like bright light therapy, exercise, omega threes, support groups, listening visits etc? It just feels that the gun has been jumped because meds are cheap and cheerful. There is good evidence for caution here.
Antidepressants can save lives but aibu to suggest in pregnancy women should be given the information necessary to make an informed decision and appropriate treatment as per NICE guidelines? I seriously hope this isn't just how it goes now in terms of dilute information about serious drugs in pregnancy.
Please or to access all these features
Please
or
to access all these features
AIBU?
to think it is not acceptable to be repeatedly told antidepressants are 'totally safe' in pregnancy with no discussion of risks or mention of psychotherapy or alternatives?
64 replies
working9while5 · 07/09/2013 13:36
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