Monday, October 6, 2008

Complications

I've been talking to anyone I can about pregnancy while on a low dosage of Sertraline. The only answer I get from officials (Drs. and nurses) is that it's 'up to me' and the risks 'aren't well known'. One website, officially, says that there is no proven increase in birth defects... while wikipedia disagrees strongly with:

 "The use of sertraline during the first trimester of pregnancy was associated with increased odds of the following birth defects:omphalocele (six-fold), anal atresia and limb reduction defects (four-fold), and septal defects (two-fold).[132]" (read article here)

So, understandably, I'm concerned about risk factors of getting pregnant. I'm on 50 mg a day, which is a really low dose, and I'm wondering if I can drop to 25 mg and still keep steady.

The hard thing is that depression/anxiety is very difficult for a developing fetus. It increases the risk of miscarriage significantly, and can effect baby birth weight (anyone remember my 5 lb 14 oz full-term baby?)

The question is, where is the balance. Obviously, the higher the intake of Sertraline, the higher the risk factors. So, where is that balance between risks? The two main factors that keep coming up in my head are:

1) I would never be able to forgive myself if something happened to my baby
2) I need to be able to function on some level

Functionality is actually a really serious concern. There's no doubt that I function better, daily, on the higher dosages of Sertraline. I ended up on 50 mg again because it also makes me incredibly nauseous, and, on occasion, increases my number of bad nights with insomnia. It also makes my "gut sick". (I'll leave it at that). Those are all common side effects.

Past the first trimester, the concern is that a baby, upon birth, would go through withdrawal from the drug. Withdrawal from Sertraline is horrible and includes, dizziness, exhaustion, nausea, and fainting. In babies this turns into high muscle-tone, anxiety, irritability, and difficulty eating.

I would appreciate thoughts/stories/insights/opinions.

4 comments:

Martie said...

El,

Here are my FWIW thoughts:

I have been in a somewhat similar boat. 6 months before we conceived Landry, I took myself off of my heavy-duty pain killers. It was hard! But I wanted everything out of my system for certain. In my case, I had to just deal with pain. I was not willing to take anything else that would actually help me because I was afraid of hurting her.

If I understand your circumstances correctly, you are reliant upon this drug and feel you cannot function without it. You feel the well-being of your family depends upon it. That puts a lot of weight on your shoulders, doesn't it?

Is it possible to delay pregnancy attempts for a few months and try other drugs that are proven safe and see how they work? I realize that it is very difficult to find something that works well. But surely Heavenly Father could help you to find that perfect medication, and then maybe that would give you peace of mind.

Of course, I also understand that timing is important for you guys. I am just trying to think of ways to alleviate your worries.

Good luck to you. I know that as you seek answers in prayer, you will know what to do.

Love you.

Martie

Eloise said...

I'm immediately starting the process of the three-week weaning off the drug that is the suggested way.

The issue is that there are no "safe" anti-anxiety medications. I think I need to jump in with faith, do what I know needs to be done and pray that there will be grace enough for me to survive without the medication. I don't like being reliant on a pill, especially when the side-effects are so hard on me. Before I was on the medication, I was able to get some calm and clarity with yoga... so maybe that's the only "safe" alternative?

Peg Lewis said...

What a great alternative! Maybe you could start it now and see how you feel and whether you think it will do.

It sounds better than worrying what you might have done to your baby, even if the risk is low.

And remember that your small newborn was due to factors other than depression. How much depression does it take to take a couple of pounds off a newborn? And is that due to depression or to behaviors people adopt when they're depressed?

Just some thoughts. You'll do the right thing.

Martie said...

Where'd ya go, El?