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Postpartum Depression

Antidepressants During Pregnancy
By Karen Kleiman, MSW
Karen KleimanQ. I have a history of depression (since I was 19) and am now 36 - no children. I'm really happy with my husband; we've just moved into a new house - major stress! and I'm okay day to day. The next thing, now that we're settled, is children, but we're both concerned about the effect of my meds on the baby, my health during and after the pregnancy particularly as my husband has seen me go through a six month stint of depression where I was hospitalized voluntarily for four months and it was horrid.

At present I'm taking 300mg Effexor XL and 600mg Lithium. I know I'll need to stop the Lithium before conceiving, but I'm not sure about the Effexor - I suppose the dosage could be reduced and then see how I do - but to stop it altogether at anytime would be disastrous - I've tried this before - tapering it off but it hasn't worked.

I had resigned myself to a life without children but I've read that others have had successful births whilst taking Effexor all the way through their pregnancy. Can you give me any advice?

A. It's a tough call and one that you and your doctor should make together.

We have some good research supporting the use of some antidepressants during pregnancy, particularly the SSRIs (serotonin selective reuptake inhibitors). Unfortunately, Effexor is on the newer side so we don't have as much hard data on it, though many doctors do prescribe it during pregnancy.

So I would suggest you have a comprehensive conversation with your doctor to discuss treatment options. You need good information so you can make an informed decision backed by confidence and comfort in the choices you make. As you know, a previous history of serious depression does increase your risk of postpartum depression so make sure you are getting sufficient support. Ask questions. Get information. If you aren't comfortable with the answers, ask again or ask someone else. Remember you need to take care of YOU first.

I'm sorry I can't be more helpful. It's important that you discuss your medication concerns with your doctor so you can get the most accurate medical advice. I wish you the best.

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