Prozac and Pregnancy
Q: I am a 34 yr. old mother of a 9 and 6 year old. After a particularly difficult last year, I had to admit that I was suffering with depression. I began a regular yoga and meditation practice, and stopped drinking alcohol, and coffee. And after much hesitation conceded to try Prozac as another healing modality. I have had an amazing recovery, which I attribute to all of the self care practices, including medication. My husband and I are looking forward to bringing another child into this world, I am wondering what information/advice you can give about pregnant moms, newborns and fluoxetine?
Is there cause for concern? Namaste
From Genevieve
A: Although there have been many healthy pregnancies and babies born to mothers
who have taken fluoxetine, It would be ideal to discontinue the fluoxetine prior to conception if you can.
Potential risks and side effects of fluoxetine use in pregnancy include:
Depletion of folic acid (you can and should supplement folic acid of course)
Depletion of melatonin (the sleep hormone)
Increased risk of minor birth defects
Increased risk of prematurity, neonatal ICU admission, and pulmonary hypertension (high blood pressure in the lung vasculature) in the baby
Withdrawal symptoms and central nervous system toxicity in baby if mother takes fluoxetine especially later in pregnancy eg. crying, jitteriness, eating & sleeping disturbances, etc.
The risks of fluoxetine to the breastfed infant include growth delays, irritability, loose stools, vomiting. Although fluoxetine is not recommended for use during breastfeeding, it is thought that the benefits of breastfeeding far outweigh discontinuing breastfeeding solely due to fluoxetine use by the mother.
If the yoga, meditation and other mind/body practices you are engaging in are also helping, you may be able to wean yourself off the fluoxetine before you conceive or soon thereafter. Acupuncture is a great modality that can help as well. If you find you really can’t do without the fluoxetine, that’s certainly better than feeling mentally unstable and the statistics do favor normal birth outcomes in most cases. It’s a balance between risks at that point, and while taking fluoxetine during pregnancy & breastfeeding is hardly an ideal situation, if it is making the best of an otherwise intolerable depression it’s probably for the best. I advise any woman facing this situation to have a frank discussion with their birth and mental health providers and seek the guidance and support particular to their situation at hand, and to seek adjunct, nontoxic treatment modalities such as you have,
including yoga, meditation, acupuncture, bodywork, breathing exercises, etc.
Eden G. Fromberg, DO, FACOOG, DABHM
SOHO OB/GYN
430 West Broadway #2A
New York, NY 10012
(212)941-0011
fax (212)941-5977
http://www.dredenfromberg.com
http://www.sohoobgyn.com
drfromberg@sohoobgyn.com
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