WebMD published an informative piece last week on why people consider quitting their antidepressants and what they should know before they do so. This is ever so pertinent to moms with postpartum depression and anxiety, many of whom are afraid to take medication for their treatment and who, if they do, want to get off of it as soon as possible.
First, let me make clear that I don’t think every woman with a perinatal mood or anxiety disorder needs to take medication. It is one method of treatment. I do think it’s important, though, to know as much as possible about why you’re taking an antidepressant, what you should expect to happen, whether you need to try something else and how to go off of it properly.
For me, some of the key takeaways of the WebMD piece were:
- “A lot of patients give up before the drug has had time to enact changes in the brain’s chemistry. Side effects are the most common reason for quitting an antidepressant within the first two weeks.” Shame on the doctor who doesn’t discuss potential side effects with you and what you can do to deal with them. Some moms get them, and others don’t, depending on which medication is being taken. Think about which side effects you can deal with for the sake of getting well, and which are deal breakers, and talk about this with your doctor. A different treatment may work better for you.
- “Some patients stop taking antidepressants because they think the drug isn’t working. It may be that their dose just needs to be adjusted …” Ask questions about your dosage. Is your doctor starting you off low, and if so, how does he or she plan to bring you up to the most effective dose? What will that process look like?
- “If you don’t see any improvement after two weeks on an antidepressant, tell your doctor.” Yes! While it does take time for the medication to build up in your system and some patience is required, you don’t need to sit around for 6 months waiting for it to start working and remaining in total misery. If you’re on the recommended dose and your symptoms haven’t improved after a few weeks you’ve got to do yourself the favor of calling and saying “This isn’t working.”
- “Quitting too soon makes it more likely depression symptoms will return.” This happens often to mothers who start feeling better and decide they can stop their treatment on their own. They are quite surprised when the illness returns. Don’t do this. Talk to your doctor first.
Go read the whole article (note: it’s 3 pages) and let me know what you think. Does this help those of you who are considering stopping your antidepressant?
Note: For those of you who say you had to stop your medication because you can’t afford it, you should be aware of the Partnership for Prescription Assistance.
It's so true. I was on Zoloft for months thinking it wasn't working for me because of all the breakthrough anxiety I was still having. I mentioned it to my doctor and she gave me a very clear talking to about how long I should take to see improvement and how often I should be checking in with her to determine if I needed to up my dose. The dose has been doubled now, but I feel like myself for the first time in a YEAR.
If you broke your arm, you'd take painkillers for that. We really need to remove the stigma from mental health drugs for people who's physicians feel it is the right course of treatment.
I suffered with Postpartum Obsessive Compulsive Disorder twice. Both times I used an antidepressant (Celexa the first time and Prozac the second)as part of my treatment. For me, antidepressants helped me to "forget" my normally unrelenting obsessive thoughts. This was crucial for being able to do Cognitive Behavioral Therapy. I was very reluctant to take medication but found Celexa and Prozac to be life-saving.
I had no choice but to quit mine. My insurance ran out and we just couldnt afford it. I can tell you that it's been months and almost every single day I find myself thinking I wish there was a way to get back on them.
I wonder if I had more education and communication about antidepressants from my prescribing physician, if I would've had more success on them.
I realize drs have to walk a fine line so as not to put the idea of certain side effects in a patient's mind (placebo effect), or create unrealistic expectations. But, for the most part my experience consisted of very little actual communication, in spite of questions. Mostly being handed some samples, reading over the lengthy (and scary!) inserts, and going over my insurance options at the pharmacist (lengthiest part).
No instructions, no guidance, no recommendations, no discussion of pills as *a* critical component (but not *the* *only* component) of a plan to get better. I've gotten misinformation – that there will be NO side effects, but mostly just a lack of information.
No discussion or technical explanation about why this particular one was chose over another and the chemistry of it. I mean, come on — this is my brain, give me a technical explanation, I can handle it! For that, I always had to rely on the (scary and inaccurate) internet.
One doctor actually prescribed a med for me because it "seemed to work before" so "lets start there". Which never felt particularly compelling or qualified opinion when I later considered whether or not it was time to quit taking it.
After going through this process over and over with an OBGYN, general practitioner, and a few different psychiatrists there just seems to be an awful lot of "trial and error" involved with different physicians and very little patient education and communication involved. No one seems particularly empowered except the marketing companies, who have resources to spare.
Maybe guidelines for patients to help them know what to ask before they start taking it would help? Perhaps more patient counseling and communication between the prescriber and prescribee is needed …
I'm no expert … but I have been in this position myself. At the time, I qualified for programs by the pharma companies to get free medicine. Might be worth talking to your doctor to see if they have more information, or perhaps someone on this board does since there are so many incredible resources.
There is a key point in this: Don't stop taking meds as soon as you start to feel better. We all don't want to be on meds if we don't have to be…but stopping them as soon as you see improvement is extremely dangerous. You need to be monitored and weaned.
Thanks for this info!
Very timely. I have decided to go off the meds on my own – I've been on them since June and have felt fine since then, but I don't want to be on them for the rest of my life. The last time I talked to my doctor she told me that generally patients stayed on antidepressants for at least a YEAR, which is not what I want to do…
Boy, I wish I read this one a year ago. That's when I decided I was well enough to wean off my meds and well here I am, one year later involved in a PPD relapse and back on the meds. Going thru it a second time with the same child, in my opinion, is so much harder than the first time. You feel like a failure the first round but part two really makes you look over your shoulder ten-fold.
Becky,
I've added a link in to the post above (see the bottom) with information on the Partnership for Prescription Assistance, which may be able to help you get your medication any way. If it was working for you, this is worth a try.
The brand of medication isn't what matters here, which is why I generally try not to talk about them. What works for you may not work for another mother. I am glad, though, that your treatment was so effective! That's great to hear.
Unfortunately, there is a lot of trial and error when it comes to psychiatric medications, and it's not due to the incompetence of the physician. It's because they really don't understand yet what will work for each person and why.
At the same time, the fact that no one gave you better instructions and guidance is a travesty.
You are NOT a failure. Period. We're glad you're here with us.
I had undiagnosed PPD in 92'. Talk about dinasaur ages, was lucky to find a MD who knew what they were talking about. Then again in 96', same deal different kid. With mental/emotional challenges on both sides of my family the entire process of birth and life changes that go with put the "health" issue of mental illness in the forefront for ME. Fastforward, 2010. Awesome, psychiatrist and therapist. Still on meds. and proud of it. I am/have been a better Mom for it. Also very lucky in so many ways. It's not the way I thought my life would be, but I would not trade it 4 the world.
Having this is not failing, it's like anything else, heart disease, diabetes…it just is in the brain.
"Brain disease". Nobody signs up for any of them YA?
STAMP OUT STIGMA…….COME OUTTA THE CLOSET. Normalize this condition ! So All moms can be helped !
MangoMomma,
Seattle
Past PSI of WA
board member
Thank you for the link!
Useful information, many thanks to the author. It is puzzling to me now, but in general, the usefulness and importance is overwhelming.
Very much thanks again and good luck!
I had the worst experience with my doctor and therapist thru my ins. My doctor that gave me my meds never told me about the side affects. In fact the meds were ordered for me thru phone. Never a one on one sit down. With him. After 3 weeks I was feeling a bit better but in between I had to keep calling his nurse to ask if all I was feeling was normal. After 3 weeks I had my first visit with him and since I cried in our session he decided to change my medication on the first day I had a horrible side affects of suicidal and again the doctor never mentioned any of this to me. I completely stopped my meds. It was the worst experience not to mention my therapist has only been available once to see her. I’m now seeing a homeopathic and doing herbs I hope all this works for me
I’m sorry that you haven’t been able to find the right help. Sometimes it takes time to find the right providers. We have a list on the postpartum progress website. I’ll leave the link here so you can see if there is someone near you. It doesn’t mean you have to take medications, but you can get some helpful advice and some therapy if you would like. http://postpartumprogress.com/womens-mental-health-treatment-programs-specialists-us-canada-australia