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Family Forum / Pregnancy / Pregnancy / January 2008prophylactic treatment for postnatal depression
Does anyone happen to know what might be the usual advice for if you have had postnatal depression, but then have gone on to have another pregnancy and not have any depression afterwards. The standard for the first pregnancy following postnatal depression seems to be to start whatever drug worked last time the day following delivery, or if the timing is such that you haven't come off meds when you get pregnant to carry on at the lowest dose. I had very severe postnatal depression after my first baby, which came out of the blue, the first 4 weeks after the birth were fab and things seemed to be going well, I was well bonded with the baby and very happy. I then had a very severe episode of postnatal depression that included some time in hospital, thankfully the early bonding meant that I continued to have a good bond with DS. It took several months to find medication which worked (poor treatment I think as it was Zoloft which worked, which probably should have been the first thing to try). I was advised that as you should stay on antidepressants and feeling well, for at least as long as you were ill for, that as this would be mid pregnancy, that I should stay on them and then for a year after the birth. We did up the dose in that year, but I think more through fear than need, I cut back down to the lowest common dose at about 8 months and tapered off them a little after the 12 month mark. That was 18 months ago. I'm not particularly averse to 50mg of Zoloft, but equally I'd rather not take it if my risk is not that much different from normal. Cheers Anne >I'm not particularly averse to 50mg of Zoloft, but equally I'd rather >not take it if my risk is not that much different from normal. > >Cheers >Anne Hi Anne, I had severe pd after my first pregnancy and also took zoloft, which worked. I had weaned myself off the med before having my dd (2nd pregnancy). Since I knew what to watch for and what treatment worked, my doctor and I took a "wait and see" attitude. He would have given me the med if I'd requested it, but we both felt it was better to determine if it was going to be necessary. As it turned out, I did not have pd after my 2nd pregnancy. Now, I did have pd after my last pregnancy, but I'd had some severe medical issues after her birth and I feel my depression was more due to those issues than anything else, so I went back on zoloft for a while. Good luck, Nan > I had severe pd after my first pregnancy and also took zoloft, which > worked. I had weaned myself off the med before having my dd (2nd [quoted text clipped - 9 lines] > to those issues than anything else, so I went back on zoloft for a > while. Thanks for taking the time to respond, Nan, am I remembering rightly that you had a big gap between 1 and 2? and also that your circumstances had changed greatly? I don't know if you remember, I had severe medical issues after my last pregnancy, though of a less acute nature than yours, but I suspect much longer lasting. Continuing to deal with those without any depression is very encouraging. However, there would be one huge difference, in the time frame I'm looking at, the hypothetical third child would be born in the US, 5000 miles away from any relatives and though we're making friends here, I got an awful lot of support last time from friends I'd had for a long time and who were single and could give me support in a very different way from anything friends here could. I suspect both those factors raise the risks somewhat. Lack of familiarity with the medical system doesn't help either, as the UK system was very supportive, my Health Visitor visited every week for a long time, it was mostly a cup of tea and a chat, but it helped an awful lot. I was also monitored very closely by a psychiatrist. I guess that's another thing to ask either my primary care doctor or obgyn at some point, would they recommend a one off meeting with a psychiatrist in the 3rd trimester to go over a complete history and see what they suggest in terms of observation. Cheers Anne "Anne Rogers" <annekh23@yahoo.co.uk> wrote in message > Does anyone happen to know what might be the usual advice for if you > have had postnatal depression, but then have gone on to have another > pregnancy and not have any depression afterwards. I think you have the cart before the horse and you need to see if you actually have a problem with it if and when you do have another baby. You know the symptoms and perhaps have a prescription for yourself and if you need them, take them. Don't assume because you have had problems in the past that you will have them again.  SignatureSue (mom to three girls) > I think you have the cart before the horse and you need to see if you > actually have a problem with it if and when you do have another baby. You > know the symptoms and perhaps have a prescription for yourself and if you > need them, take them. Don't assume because you have had problems in the past > that you will have them again. I think if PPD was something you could spot one day and be pretty confident you had it and then treatment worked fast, then that would be the obvious thing to do. But it isn't, some blues after the birth is normal, I had none of that when I did go on to develop postnatal depression and when I didn't I was a tearful wreck for about 48 hours. You could compare it to giving antibiotics in labour for group B strep, you're not giving them to remove the group B strep colonisation from the mother, nor to treat an already infected baby, you're trying to prevent it, some people feel any risk of passing on group B strep is too high and will take the antibiotics with accompanying medicalisation etc. others consider the risk low unless other factors arise and each individual has to come to there own conclusion. There isn't a test for postnatal depression and even when you've been through it and are in contact with professionals, it's quite easy for symptoms to be masked for a while and for the individual to not notice, pass them off as temporary things, result of a bad night etc. and the same for people close to them. Then the treatment comes too late and it takes time to work and in the time it takes to work mood can still go down an awful lot. Having a prescription ready does sounds like a good idea though, it would definitely remove a fear factor of what to do in an emergency and the possibility of having to give a history to a stranger at a time when that's the last thing you want to do! Cheers Anne |
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