Issue link: http://cp.revolio.com/i/869597
Should I Take a Medication? 3 Steps to an Easier Decision Should you take an an depressant or not? Take this quick quiz to help you answer this ques on. YES NO I have severe depression, frequent relapses, or just feel I can't cope with trying natural approaches or wai ng to see if they work. YES NO I've tried the natural therapies and they just don't work for me. YES NO I feel more confident in the effec veness or safety of medica ons than in natural therapies. YES NO I understand that there is a risk to taking these drugs in pregnancy, including the risk of my baby having a heart defect, and I can accept that risk. If you answered YES to any of the above statements, then an an depressant might be the best choice for you, at this me. If you answered no, to all of these ques ons, are not having thoughts of self-harm, and have a solid support network, then it might be appropriate to try non-pharmacologic methods first. Reducing Your Baby's Risks from Antidepressant Exposure During Pregnancy I am sure that if you have decided you need to use an an depressant, this was not easy. Trust, that you are making the best choice at this me for you and your baby. To reduce the risks of an depressant exposure for you and baby: • Choose a medica on that is known to result in the lowest fetal/neonatal exposure whenever possible. Prozac (fluoxe ne) is the best-studied medica on with the highest safety profile; however, it has a tendency to accumulate in the breas eeding baby, thus in spite of controversy over poten ally being able to cause congenital defects (teratogenicity), Zolo (sertraline) is typically the first line medica on recommended during pregnancy. • Avoid the use of newly released an depressant medica ons while pregnant – use only those that have been me-tested in pregnant women. • Use the lowest effec ve dose in the first trimester, increasing in the second and third trimesters, as needed to maintain symptom control. • If you are pregnant and wish to try to lower your dose, do so by tapering down by 10% each week to minimize the poten al for relapse, remaining at the lowest possible dose at which your symptoms stay well controlled. • Add in non-supplement, non-pharmacologic treatments such as light therapy, yoga, and cogni ve behavioral therapy, all of which have been found to be effec ve and do not interfere with your medica on, but might allow you to effec vely lower your dose. What if I'm Already on a Medication? If you got pregnant while already on an an depressant, set up a me to discuss the risks of that medica on on your pregnancy with your midwife or OB. Work with your care provider to switch you to the safest possible medica on that will work for you, and at the appropriate dose. If you are already on a medica on that is preferred for safety in pregnancy, at a dose that is really doing the job for you, and you are past the first trimester, then some mes the best thing may actually, be to stay at that dose because some mes lowering the dose just leads to rebound symptoms that are hard to control at a lower dose. These really are tough decisions. While a non-pharmacologic approach whenever possible may be the ideal, keeping yourself in a healthy mental space is also essen al for a healthy pregnancy and transi on to motherhood feeling prepared and happy to meet and care for your new baby. References Benard, A. et al. The risk of major cardiac malforma ons associated with paroxe ne use during the first trimester of pregnancy: A systema c review and meta-analysis. Bri sh Journal of Clinical Pharmacology.doi: 10.1111/bcp.12849. Hogg K, Price EM, et al. (2012). Prenatal and perinatal environmental influences on the human fetal and placental epigenome. Clin Pharmacol Ther, 92(6):716-26. Misri, S and S Lusskin. (2013). Depression in pregnant women: Management. h p://www.uptodate.com/contents/depression-in- pregnant-women-management?source=see_link Abby's Magazine - Volume 5 Issue 5| Page 25