If this is your first visit, be sure to check out the FAQ by clicking the link above. You may have to register before you can post: click the register link above to proceed. To start viewing messages, select the forum that you want to visit from the selection below. |
|
|
|
Thread Tools | Display Modes |
#1
|
|||
|
|||
Antidepressants in pregnancy and breastfeeding
Can anyone point me to any good web resources on antidepressant use in
pregnancy (and, while I'm at it, while breastfeeding)? (Just in case anyone was wondering, I'm asking professionally and not personally...) TIA, All the best, Sarah -- http://www.goodenoughmummy.typepad.com "That which can be destroyed by the truth, should be" - P. C. Hodgell |
#2
|
|||
|
|||
Antidepressants in pregnancy and breastfeeding
When I found out I was pregnant the first time, I was concerned because I
was and am taking 75 mg of Effexor per day. The doctor said it was better to be in a good state of mind than off the drug and being up and down mood wise for me and the baby. There has only been one study done (she showed me in a medical book nothing from the net) and that study was done using Prozac. There were no ill effects and I didn't find any either. In fact, it helped with any post partum depression I may have had as well. Effexor is milder than prozac in that there aren't as many side effects as I have seen with Prozac. -- ..oO rach Oo. "Sarah Vaughan" wrote in message ... Can anyone point me to any good web resources on antidepressant use in pregnancy (and, while I'm at it, while breastfeeding)? (Just in case anyone was wondering, I'm asking professionally and not personally...) TIA, All the best, Sarah -- http://www.goodenoughmummy.typepad.com "That which can be destroyed by the truth, should be" - P. C. Hodgell |
#3
|
|||
|
|||
Antidepressants in pregnancy and breastfeeding
"Anne Rogers" wrote in message ... Effexor is milder than prozac in that there aren't as many side effects as I have seen with Prozac. I don't think "milder" and "stronger" are particularly helpful descriptive words when it comes to antidepressants in the same way that they would be with, say, opiate based painkillers. In this case it's not even a direct comparison as Effexor is an SNRI, whereas Prozac is an SSRI, and start doses will be different to account for the difference in effect from the same dose, so for Effexor, the initial dose is 75mg, whereas for Prozac it's 20mg. Effexor is still low down the preferred list for breastfeeding, but generally tends to be viewed as ok if necessary whereas Prozac would be avoid if possible for breastfeeding. So if someone is already on Effexor, there is probably no indicator to change, but it would probably fall in the category of one you wouldn't commence use in pregnancy or breastfeeding unless other drugs had proved unhelpful. By milder I meant it doesn't have the effects that Prozac does. Prozac has been known to make people worse - much worse along with hallucinations and allergic like reactions. Milder is what my DOCTOR described it as and she would know, right? Also, a few friends of mine have tried Prozac... some with great results but many with horrible results yet no one I know on effexor has had the problems of Prozac. From the documented in formation she had me read about the tests done on Prozac and pregnancy/breastfeeding there were no ill effects of it and Prozac is the only drug they have done tests on. Like I said and like she (the doctor) said, I would rather be a calm pregnant lady and breastfeeding mother than a complete wreck. How is being depressed enough to kill yourself or riding the waves of anxiety helpful to anyone? |
#4
|
|||
|
|||
Antidepressants in pregnancy and breastfeeding
Can anyone point me to any good web resources on antidepressant use in pregnancy (and, while I'm at it, while breastfeeding)? (Just in case anyone was wondering, I'm asking professionally and not personally...) I think kellymom comes up about the best http://www.kellymom.com/health/meds/...hale10-02.html I seem to recall there was a fairly detailed page on the breastfeeding network site too. Neither of those directly cover pregnancy, Hales would have slightly more detail for pregnancy, but still only very minimal, certainly nothing like the choice hierachy of breastfeeding. As I'm sure you know, it's not something you want to be switching around without clear need, either not working or side effects too great, so when selecting a drug for pregnancy, there needs to be a long term plan for breastfeeding as well, which then leave sertraline as the drug of choice for pregnancy as well as breastfeeding, and it's risks in pregnancy seem to be very very slight increase in neural tube defects, so taking the higher, precription only dose of folic acid upto 12 weeks may be adviseable, but I don't think there is any research that confirms that in this particular instance it reduces the risk (note, it's not adviseable to take it beyond 12 weeks, there is no benefit and an increased risk of breastcancer), the other was a slight increased risk of IUGR, but even with a history of IUGR, that slight risk was not enough for me to not take sertraline, the risks of not taking it were probably much greater, as it turned out that baby didn't have IUGR. Prozac would appear to be the drug of choice for pregnancy, simply because it's been around longer, so there is more data, but everything points to other ssris actually being better. http://www.womensmentalhealth.org/topics/pregnancy.html looks like a pretty good article for pregnancy, but doesn't mention doses, the max dose can be 4 or more times the min dose, so you'd expect there to be a difference, it also doesn't mention breastfeeding, but I do feel that in choosing a drug and a dosage when pregnancy is being considered you have to consider early breastfeeding. The other thing to consider (I'm sure you've thought of this anyway), is that if the pregnancy is planned, or rather the planning of it is mentioned to the care provider then that is when there is most chance of making some kind of chance actually having an effect on outcomes, even it it's just lets see how you get on with a lower dose, whereas if the women doesn't present until early pregnancy, the congential defects side of things has probably already been set in stone and if there is a need for high doses, it may be that waiting to reduce at 37 weeks if possible would have exactly the same effect as reducing doses from that moment, with much less risk to the mother and they can then increase the dose again if desired straight after delivery. It's also worth noting, that even if you feel care can remain in the hands of the GP, it should still be possible to contact, say, the hospital pharmacist about prescribing, as they have the most uptodate information and in my case, it was them and not any psychiatrist who knew that sertraline was the drug of choice for breastfeeding mothers, I may be remembering wrong, but they also seemed to indicate it was the drug of choice for postnatal depression, regardless of breastfeeding. Cheers Anne |
#5
|
|||
|
|||
Antidepressants in pregnancy and breastfeeding
Effexor is milder than prozac in that there aren't as many side effects as
I have seen with Prozac. I don't think "milder" and "stronger" are particularly helpful descriptive words when it comes to antidepressants in the same way that they would be with, say, opiate based painkillers. In this case it's not even a direct comparison as Effexor is an SNRI, whereas Prozac is an SSRI, and start doses will be different to account for the difference in effect from the same dose, so for Effexor, the initial dose is 75mg, whereas for Prozac it's 20mg. Effexor is still low down the preferred list for breastfeeding, but generally tends to be viewed as ok if necessary whereas Prozac would be avoid if possible for breastfeeding. So if someone is already on Effexor, there is probably no indicator to change, but it would probably fall in the category of one you wouldn't commence use in pregnancy or breastfeeding unless other drugs had proved unhelpful. Cheers Anne |
#6
|
|||
|
|||
Antidepressants in pregnancy and breastfeeding
By milder I meant it doesn't have the effects that Prozac does. Prozac has
been known to make people worse - much worse along with hallucinations and allergic like reactions. Milder is what my DOCTOR described it as and she would know, right? Also, a few friends of mine have tried Prozac... some with great results but many with horrible results yet no one I know on effexor has had the problems of Prozac. From the documented in formation she had me read about the tests done on Prozac and pregnancy/breastfeeding there were no ill effects of it and Prozac is the only drug they have done tests on. Like I said and like she (the doctor) said, I would rather be a calm pregnant lady and breastfeeding mother than a complete wreck. How is being depressed enough to kill yourself or riding the waves of anxiety helpful to anyone? I'm not critisising you taking it or anything, so there is no need to be defensive, you were already on it, it was working, it makes no sense to change and as you say there is no evidence of it being a problem in pregnancy (though there have been cases reported of temporary problems in newborns). Perhaps as a substitute for the word milder, something like more benign might be appropriate, just because a doctor describes it as something doesn't mean it's a good way to describe it, it's possible that a doctor justifying a choice of drug by saying it is milder would make them feel as if there depression is not being taken seriously, when what they really mean as that it's less likely to cause side effects. One problem with prozac is that the generic has been available for a longer time than other SSRIs and there are very many producers of the generic, so even going to the same pharmacy, you may not get the same formulation each time and some formulations are more prone to the common side effect, nausea, than others. Of course it has the well publicised increase in suicide with Prozac, but it is not something that affects solely Prozac, Effexor apparently doubles the suicide risk and similar is true for most many antidepressants, which just emphasises the importance of closely watching any person who is prescribed antidepressants. There is no one antidepressant which is the first choice prescription for all patients and what is right for one person may well not be right for another, and whilst it's possible to have a ranking for preference when considering one thing, such as breastfeeding, even when that is the situation, it doesn't mean that it's the right thing to take the one from the top of the list (Zoloft). Also, doctors are influenced by pharmacutical companies and are likely to go through phases of regularly prescribing one particular antidepressant, possibly without any clear evidence to do so. Prescribing in depression is complex and I suspect that over time the move will be towards having specialist prescribers, possibly a specialist nurse amongst a group of doctors, etc. Anne |
#7
|
|||
|
|||
Antidepressants in pregnancy and breastfeeding
Sarah Vaughan wrote:
Can anyone point me to any good web resources on antidepressant use in pregnancy (and, while I'm at it, while breastfeeding)? (Just in case anyone was wondering, I'm asking professionally and not personally...) During pregnancy http://www.motherisk.org/index.jsp http://www.mayoclinic.com/health/ant...ssants/DN00007 http://www.hc-sc.gc.ca/ahc-asc/media...2006_11_e.html And while breastfeeding http://neonatal.ttuhsc.edu/lact/ Elle |
#8
|
|||
|
|||
Antidepressants in pregnancy and breastfeeding
Anne Rogers wrote: Effexor is milder than prozac in that there aren't as many side effects as I have seen with Prozac. I don't think "milder" and "stronger" are particularly helpful descriptive words when it comes to antidepressants in the same way that they would be with, say, opiate based painkillers. In this case it's not even a direct comparison as Effexor is an SNRI, whereas Prozac is an SSRI, and start doses will be different to account for the difference in effect from the same dose, so for Effexor, the initial dose is 75mg, whereas for Prozac it's 20mg. Effexor is still low down the preferred list for breastfeeding, but generally tends to be viewed as ok if necessary whereas Prozac would be avoid if possible for breastfeeding. So if someone is already on Effexor, there is probably no indicator to change, but it would probably fall in the category of one you wouldn't commence use in pregnancy or breastfeeding unless other drugs had proved unhelpful. Cheers Anne |
#9
|
|||
|
|||
Antidepressants in pregnancy and breastfeeding
I have been taking "Effexor" for 8 yrs through 3 pregnancies. To date
there have been no negative side effects through the pregnancies or breast-feeding them for a yr (excluding the youngest who is ten months and still breast-feeding). and to have to switch to a new drugI would have had to not take anything for 2 weeks and dealt with pregnancy hormones which would have been impossible.My dr had remarked that some "Effexor" babies can be a lil jittery when there born. I didn't find this to be so maybe because they were still receiving a minute dose in my breast-milk. Can't quite be sure. BTW the initial dose for "Effexor" is 37.5mg. Anne Rogers wrote: Effexor is milder than prozac in that there aren't as many side effects as I have seen with Prozac. I don't think "milder" and "stronger" are particularly helpful descriptive words when it comes to antidepressants in the same way that they would be with, say, opiate based painkillers. In this case it's not even a direct comparison as Effexor is an SNRI, whereas Prozac is an SSRI, and start doses will be different to account for the difference in effect from the same dose, so for Effexor, the initial dose is 75mg, whereas for Prozac it's 20mg. Effexor is still low down the preferred list for breastfeeding, but generally tends to be viewed as ok if necessary whereas Prozac would be avoid if possible for breastfeeding. So if someone is already on Effexor, there is probably no indicator to change, but it would probably fall in the category of one you wouldn't commence use in pregnancy or breastfeeding unless other drugs had proved unhelpful. Cheers Anne |
#10
|
|||
|
|||
Antidepressants in pregnancy and breastfeeding
I have been taking "Effexor" for 8 yrs through 3 pregnancies. To date
there have been no negative side effects through the pregnancies or breast-feeding them for a yr (excluding the youngest who is ten months and still breast-feeding). and to have to switch to a new drugI would have had to not take anything for 2 weeks and dealt with pregnancy hormones which would have been impossible.My dr had remarked that some "Effexor" babies can be a lil jittery when there born. I didn't find this to be so maybe because they were still receiving a minute dose in my breast-milk. Can't quite be sure. BTW the initial dose for "Effexor" is 37.5mg. 37.5mg is an available dose, I looked in up the BNF a pharmaceutical guide for doctors in the UK and it gave the starting dose as 75mg, but as divided doses due to the short half life, so 37.5 twice a day. Some people may end up on 37.5mg (particularly when it's being used for treating anxiety), but it was pretty clear that in the absence of any mitigating circumstances 75mg would be the starting dose. Its possible that a similar guide in America doesn't give the same recommendation, though other online sources suggest 75mg as the starting dose too, so maybe there has been some confusion between daily dose and per taking dose, I had to use daily as prozac is usually taken once a day. I've always wondered about the impact of breastfeeding on protecting newborns from side effects, but I've never been able to get any answers. Anne |
|
Thread Tools | |
Display Modes | |
|
|
Similar Threads | ||||
Thread | Thread Starter | Forum | Replies | Last Post |
misc.kids FAQ on Breastfeeding Past the First Year | [email protected] | Info and FAQ's | 0 | January 18th 06 05:47 AM |
misc.kids FAQ on Breastfeeding Past the First Year | [email protected] | Info and FAQ's | 0 | September 29th 04 05:17 AM |
misc.kids FAQ on Breastfeeding Past the First Year | [email protected] | Info and FAQ's | 0 | February 16th 04 09:58 AM |
misc.kids FAQ on Breastfeeding Past the First Year | [email protected] | Info and FAQ's | 0 | January 16th 04 09:15 AM |
Recent Articles of Interest (Support-related) | Chookie | Breastfeeding | 0 | November 1st 03 11:53 AM |