Celexa for PPD?

[oregonchick]

I saw a doc today for the depression and she prescribed me 40mg of Celexa
even after we discussed Zoloft. The paper that came with the prescription
said in bold letters, "DO NOT USE WHEN BREASTFEEDING". Then I get home and
read things online that really freak me out. Now I don'y know what to
do-take the Celexa, try to push for a different drug, stop bf'ing, or tough
out the depression. Can anyone help?

[Amy]

oregonchick wrote:
> I saw a doc today for the depression and she prescribed me 40mg of Celexa
> even after we discussed Zoloft. The paper that came with the prescription
> said in bold letters, "DO NOT USE WHEN BREASTFEEDING". Then I get home and
> read things online that really freak me out. Now I don'y know what to
> do-take the Celexa, try to push for a different drug, stop bf'ing, or tough
> out the depression. Can anyone help?

Did the doctor give you a reason why she wouldn't give you Zoloft?

Don't stop breastfeeding. I'd go to a different doctor over this. Why
force you to use an anti-depressant that's incompatible with BF when
there is one that is readily available that IS compatible with BF?
That doesn't make any sense to me at all.

Hang in there, you've done the hardest part - admitting that you need
help. Now it's just a matter of getting you the right help.

I wish I could send you my zoloft - I have tons.

Amy

[Andrea S]

"oregonchick" wrote in message ...

>I saw a doc today for the depression and she prescribed me 40mg of Celexa
>even after we discussed Zoloft. The paper that came with the prescription
>said in bold letters, "DO NOT USE WHEN BREASTFEEDING". Then I get home and
>read things online that really freak me out. Now I don'y know what to
>do-take the Celexa, try to push for a different drug, stop bf'ing, or tough
>out the depression. Can anyone help?
>

I went armed with printouts from kellymom, I had a big debate but I came out
with the prescription of Zoloft (sertraline).

Andrea mom of 6 (and considering being sterilised)

[Mum of Two]

"oregonchick" > wrote in message
...
>I saw a doc today for the depression and she prescribed me 40mg of Celexa
>even after we discussed Zoloft. The paper that came with the prescription
>said in bold letters, "DO NOT USE WHEN BREASTFEEDING". Then I get home and
>read things online that really freak me out. Now I don'y know what to
>do-take the Celexa, try to push for a different drug, stop bf'ing, or tough
>out the depression. Can anyone help?

Did she know you were breastfeeding? If so, I agree you should find another
Dr. I'm off to see a new one on Tuesday and I'm going to ask for Zoloft.


--
Amy
Mum to Carlos born sleeping 20/11/02,
& Ana born screaming 30/06/04
http://www.freewebs.com/carlos2002/
http://www.babiesonline.com/babies/a/ana%5Fj%5F2004/
My blog: http://spaces.msn.com/members/querer-hijo-querer-hija/

[Anne Rogers]

erm, that's a bit rubbish, Zoloft is the absolute best for breastfeeding as
it goes through to the milk the least, general opinion says it should be the
first drug you try

Anne

[Anne Rogers]

this is what kellymom says

Celexa has a 4.3-16 nanogram/kg blood plasma level, but transfer rate is
higher via milk. Use with caution and watch infant for side effects (per
Hale, "There have been two cases of excessive somnolence, decreased feeding,
and weight loss in breastfed infants.").

whereas for Zoloft it says

a.. Zoloft is the "best drug choice so far". It has a low, low transfer rate
to breastmilk (17-173 ug/liter) in mothers taking up to 150 mg/day. In one
excellent study of 11 mother/infant pairs, the zoloft was undetectable in 7
of the 11 breastfeeding infants' serum and minimal in the other infants. In
two other studies of one and three mother/infant pairs respectively, zoloft
was undetectable in the plasma of all 4 infants. A theoretical concern with
Zoloft is that some babies may not gain weight as rapidly or as well when
breastfed by moms on Zoloft; so weight gain should be monitored and dosage
tweaked as necessary.


Hale gives the hierachy of choice as follows, so Celexa is not the worst,
but not the best either, it should be used if there is a reason not to use
the others
a.. Zoloft
a.. Paxil
a.. Celexa
a.. Effexor
a.. Prozac

This is sad for me as my GP wasn't prepared to prescribe SSRIs at all whilst
I was breastfeeding, though he didn't suggest I stopped, but after
attempting something else he referred me to someone who should have known
better who gave me Prozac. I don't know if it caused any problems for baby I
was too ill to notice, Prozac did horrible things to me, not physical side
effect, but mental ones and after about 6 weeks I refused to take it, I went
drug free for a while, then nearly killed myself and then someone actually
decided to use their brain and find out what was the best drug for a
breastfeeding mum and I went on Zoloft, they say something like 6-8 weeks
for best effect, but honestly there was a pretty good effect within 2 weeks.

Anne

[oregonchick]

"Amy" > wrote in message
oups.com...
>
> oregonchick wrote:
>> I saw a doc today for the depression and she prescribed me 40mg of Celexa
>> even after we discussed Zoloft. The paper that came with the
>> prescription
>> said in bold letters, "DO NOT USE WHEN BREASTFEEDING". Then I get home
>> and
>> read things online that really freak me out. Now I don'y know what to
>> do-take the Celexa, try to push for a different drug, stop bf'ing, or
>> tough
>> out the depression. Can anyone help?
>
> Did the doctor give you a reason why she wouldn't give you Zoloft?

We never discussed Celexa, only Zoloft. Then she said she'd call the
prescription over to the pharmacy. I didn't know it was Celexa until I got
home. I haven't taken any, and plan to call the doctor to see if that's
really what she meant to prescribe.

> I wish I could send you my zoloft - I have tons.

Uh, I'll send you my address?

[oregonchick]

"Mum of Two" > wrote in message
...
> "oregonchick" > wrote in message
> ...
>>I saw a doc today for the depression and she prescribed me 40mg of Celexa
>>even after we discussed Zoloft. The paper that came with the prescription
>>said in bold letters, "DO NOT USE WHEN BREASTFEEDING". Then I get home
>>and read things online that really freak me out. Now I don'y know what to
>>do-take the Celexa, try to push for a different drug, stop bf'ing, or
>>tough out the depression. Can anyone help?
>
> Did she know you were breastfeeding? If so, I agree you should find
> another Dr. I'm off to see a new one on Tuesday and I'm going to ask for
> Zoloft.

Yes. She was a midwife..

[Sue]

"oregonchick" > wrote in message
> We never discussed Celexa, only Zoloft. Then she said she'd call the
> prescription over to the pharmacy. I didn't know it was Celexa until I
got
> home. I haven't taken any, and plan to call the doctor to see if that's
> really what she meant to prescribe.

Maybe she made a mistake. Perhaps her drug of choice for depression is
Celexa and she is used to writing that particular prescription without
thinking. Can you not just call her and tell her that you thought she was
going to prescribed Zoloft? I wouldn't switch doctors, that seems totally
silly to me, but rather talk with her about it and see what happens at that
point.
--
Sue (mom to three girls)

[Kmom]

I started on Lexapro (active ingredient of Celexa) when ds was 4 months
old. It worked great for me and he did great.
Hales only concern is somnolence in the newborn, my son showed no side
effects, he also didn't show any side effects from the occasional Xanax
or Klonopin I took.
I started on 10 of Lexapro and worked my way up to 20mg. I fully intend
on going back on it as soon as this baby is the same age (is usually
the time when I crash)

Take care.

Karen

[Anne Rogers]

>> Did she know you were breastfeeding? If so, I agree you should find
>> another Dr. I'm off to see a new one on Tuesday and I'm going to ask for
>> Zoloft.
>
> Yes. She was a midwife..

well, I'm not precisely sure what you mean by midwife, as a midwife in the
UK would not be able to prescribe, so she's really not the best person to be
treating this, midwives have very limited knowledge of PPD and no knowledge
of any other depression

Anne

[Anne Rogers]

>I started on Lexapro (active ingredient of Celexa) when ds was 4 months
> old. It worked great for me and he did great.
> Hales only concern is somnolence in the newborn, my son showed no side
> effects, he also didn't show any side effects from the occasional Xanax
> or Klonopin I took.
> I started on 10 of Lexapro and worked my way up to 20mg. I fully intend
> on going back on it as soon as this baby is the same age (is usually
> the time when I crash)

Betsy's baby is much younger, I loose track, but I think only about 6 weeks,
I was also thinking the dose sounded high (which is now backed up by the
doses you've had), even with very severe depression doctors usually start at
the lowest dose and work up, Zoloft is a slightly higher dose, usually start
at 50mg, even with my very severe depression this had a noticeable affect
very quickly, though we did up it to 100mg after a month or so. I'm very
suspicious of this prescriber, 40mg would seem to be the highest dose
available as a single tablet, but I checked the BNF (book british doctors
use for prescribing) and it suggests starting dose to be 20mg, as does the
packet insert that I managed to download for Celexa.

Karen, obviously this it right for you, but with a younger infant when there
are better drugs available it plain doesn't make sense, I'm also concerned
about the prescriber ignoring all guidelines as to initial dose.

Anne

[Anne Rogers]

>> Did the doctor give you a reason why she wouldn't give you Zoloft?
>
> We never discussed Celexa, only Zoloft. Then she said she'd call the
> prescription over to the pharmacy. I didn't know it was Celexa until I
> got home. I haven't taken any, and plan to call the doctor to see if
> that's really what she meant to prescribe.

huh, she may have made a mistake, particularly as she seems to have also got
the dosage wrong, it would be very wierd for you to have a discussion about
one drug and then the doc deliberately give you something else. They would
usually say "now I see what you are saying, but...."

Anne

[oregonchick]

"Anne Rogers" > wrote in message
...
>
>>> Did she know you were breastfeeding? If so, I agree you should find
>>> another Dr. I'm off to see a new one on Tuesday and I'm going to ask for
>>> Zoloft.
>>
>> Yes. She was a midwife..
>
> well, I'm not precisely sure what you mean by midwife, as a midwife in the
> UK would not be able to prescribe, so she's really not the best person to
> be treating this, midwives have very limited knowledge of PPD and no
> knowledge of any other depression

you are right that she is not the best person to be treating this. It was
my understanding that she was a nurse practitioner, which can prescribe
drugs. She told me she was a midwife. When I called to make an appt for
PPD, this is who they scheduled me with...

[Amy]

oregonchick wrote:
> "Amy" > wrote in message
> oups.com...
> >
> > oregonchick wrote:
> >> I saw a doc today for the depression and she prescribed me 40mg of Celexa
> >> even after we discussed Zoloft. The paper that came with the
> >> prescription
> >> said in bold letters, "DO NOT USE WHEN BREASTFEEDING". Then I get home
> >> and
> >> read things online that really freak me out. Now I don'y know what to
> >> do-take the Celexa, try to push for a different drug, stop bf'ing, or
> >> tough
> >> out the depression. Can anyone help?
> >
> > Did the doctor give you a reason why she wouldn't give you Zoloft?
>
> We never discussed Celexa, only Zoloft. Then she said she'd call the
> prescription over to the pharmacy. I didn't know it was Celexa until I got
> home. I haven't taken any, and plan to call the doctor to see if that's
> really what she meant to prescribe.

It must have been a mistake. I'm hoping to find out that you have
Zoloft in hand by the time I get to the end of this thread.

> > I wish I could send you my zoloft - I have tons.
>
> Uh, I'll send you my address?

If it weren't a felony, I totally would. I only commit misdemeanors
for people on newsgroups - felonies are reserved for friends and
family. :)

Amy

[Amy]

Anne Rogers wrote:

> Betsy's baby is much younger, I loose track, but I think only about 6 weeks,
> I was also thinking the dose sounded high (which is now backed up by the
> doses you've had), even with very severe depression doctors usually start at
> the lowest dose and work up, Zoloft is a slightly higher dose, usually start
> at 50mg, even with my very severe depression this had a noticeable affect
> very quickly, though we did up it to 100mg after a month or so.

I started at 25 mg, then 50, then to 100 before it did me any good, but
I tapered up (is that even a phrase?) in that order. They had cards at
the doctor's office with samples of it, and it was a punch out (like
birth control) to keep you from taking the wrong amount too quickly.
'Course, then they gave me a ton of samples (they were about to expire)
so I had to do math every morning (am I going to take 4 25s, 2 25s and
a 50, or 2 50s today?), which kind of defeated the purpose of the
cards...

Amy

[Anne Rogers]

> I started at 25 mg, then 50, then to 100 before it did me any good, but
> I tapered up (is that even a phrase?) in that order. They had cards at
> the doctor's office with samples of it, and it was a punch out (like
> birth control) to keep you from taking the wrong amount too quickly.
> 'Course, then they gave me a ton of samples (they were about to expire)
> so I had to do math every morning (am I going to take 4 25s, 2 25s and
> a 50, or 2 50s today?), which kind of defeated the purpose of the
> cards...
>
interesting, it's not available in 25s here, though whatever you take it is
normal to start low and work up, I had a friend who was really really ill,
she was in hospital and she started on prozac, they gave it here in really
tiny doses to start with, smaller than tablets, she had to take it as a
solution

Anne

[Anne Rogers]

>> well, I'm not precisely sure what you mean by midwife, as a midwife in
>> the UK would not be able to prescribe, so she's really not the best
>> person to be treating this, midwives have very limited knowledge of PPD
>> and no knowledge of any other depression
>
> you are right that she is not the best person to be treating this. It was
> my understanding that she was a nurse practitioner, which can prescribe
> drugs. She told me she was a midwife. When I called to make an appt for
> PPD, this is who they scheduled me with...


grr, I would never say over the phone what the problem was, there are things
I would be very happy to go to see a nurse for, I would go for repeat
prescriptions for depression, but the first prescription, no way, I'd go
back, see the proper doctor and maybe consider a polite note to the clinic
manager (or whoever is in charge) that you didn't think this was
appropriate. She might be great for talking to etc. but someone like this
really shouldn't be prescribing antidepressants, personally I feel that GPs
should not prescribe them either, it should be left to psychiatrists, I've
seen GPs make too many mistakes, one poor friend of mine had some kind of
postviral fatigue and she was prescribed anti depressants and she ended up
depressed! She was on different ones for 3 years and eventually she just
went off them and got better, shortly afterwards her marriage broke up and
she has coped fine, but her marriage may never have even broke up had she
not been so ill. GPs also have a tendancy to take you off them too quickly,
with not enough monitoring, psychiatrists say you should be on them and well
for as long as you have been ill. For me this would have meant stopping
during pregnancy, but we decided that I should continue a low dose to
protect me from the approaching postnatal period. I've been through one
postnatal period with horrendous management, only getting the drug I needed
after 6 months, but after I had nearly died twice (once because I tried
another because I had such a bad reaction to a drug), now I'm in another
postnatal period under the supervision of an expert and I'm pretty good, not
perfect, but comparatively on top of the world.

Anne

[Kmom]

I couldn't remember how old her baby was.
One would need less Lexapro than Celexa as it is a 'purer' drug.
There are a few qualifiers on why I was put on Lexapro vs another SSRI.
I wasn't being treated primarily for depression (but for anxiety, my
depression was secondary to the anxiety) and I had already been on
Zoloft which
didn't work for me and the side effects were wicked.
I hope that she can find SOMETHING that works.
To oregonchick-
your best bet would be to get an appt with a psychatrist who has
experience/specializes in PPD.
My first bout of PPD/anxiety was "treated" by a family physician. She
threw a Zoloft prescription at me and sent me on my way-which is BAD
for anxiety. Second time around I saw a psych and he actually listened
to me, looked at the whole picture and treatment was successful.
Psych's have much more experience with these drugs and their efficacy
and side effects. I was fortunate to fall in with one who had treated
tons of breastfeeding mothers and was up on what was what.

[oregonchick]

"Amy" > wrote in message
oups.com...
>
> oregonchick wrote:
>> "Amy" > wrote in message
>> oups.com...
>> >
>> > oregonchick wrote:
>> >> I saw a doc today for the depression and she prescribed me 40mg of
>> >> Celexa
>> >> even after we discussed Zoloft. The paper that came with the
>> >> prescription
>> >> said in bold letters, "DO NOT USE WHEN BREASTFEEDING". Then I get
>> >> home
>> >> and
>> >> read things online that really freak me out. Now I don'y know what to
>> >> do-take the Celexa, try to push for a different drug, stop bf'ing, or
>> >> tough
>> >> out the depression. Can anyone help?
>> >
>> > Did the doctor give you a reason why she wouldn't give you Zoloft?
>>
>> We never discussed Celexa, only Zoloft. Then she said she'd call the
>> prescription over to the pharmacy. I didn't know it was Celexa until I
>> got
>> home. I haven't taken any, and plan to call the doctor to see if that's
>> really what she meant to prescribe.
>
> It must have been a mistake. I'm hoping to find out that you have
> Zoloft in hand by the time I get to the end of this thread.
>
>> > I wish I could send you my zoloft - I have tons.
>>
>> Uh, I'll send you my address?
>
> If it weren't a felony, I totally would. I only commit misdemeanors
> for people on newsgroups - felonies are reserved for friends and
> family. :)

Oh I know! I was just kidding... I just wish it were easier to get what
you need from your doctor.

[[email protected]]

oregonchick > writes:
: I saw a doc today for the depression and she prescribed me 40mg of Celexa
: even after we discussed Zoloft. The paper that came with the prescription
: said in bold letters, "DO NOT USE WHEN BREASTFEEDING". Then I get home and
: read things online that really freak me out. Now I don'y know what to
: do-take the Celexa, try to push for a different drug, stop bf'ing, or tough
: out the depression. Can anyone help?

Celexa is L3 and has a longer half-life. Why would the doctor prescribe
it if he knew this? Get him to change or go to an new doctor.

Larry

[Mogget]

In message >, Anne Rogers
> writes

>Hale gives the hierachy of choice as follows, so Celexa is not the worst,
>but not the best either, it should be used if there is a reason not to use
>the others
>a.. Zoloft
>a.. Paxil
>a.. Celexa
>a.. Effexor
>a.. Prozac

IIRC, Paxil is aka Seroxat/paroxetine.

A now well-known POSSIBLE side effect is utterly horrendous suicidal
depression.

This happened to me. I was lucky to survive it.

Treat with extreme caution.
--
Mogget

[Anne Rogers]

"Mogget" > wrote in message
...
> In message >, Anne Rogers
> > writes
>
>>Hale gives the hierachy of choice as follows, so Celexa is not the worst,
>>but not the best either, it should be used if there is a reason not to use
>>the others
>>a.. Zoloft
>>a.. Paxil
>>a.. Celexa
>>a.. Effexor
>>a.. Prozac
>
> IIRC, Paxil is aka Seroxat/paroxetine.
>
> A now well-known POSSIBLE side effect is utterly horrendous suicidal
> depression.
>
> This happened to me. I was lucky to survive it.
>
> Treat with extreme caution.

the same is true with Prozac, I'm not aware of this being such a high risk
with the others, I also had this problem with prozac, so I decided to stop
taking it, figureing I'd rather be low all the time than fine for 5 days and
suicidal for 2 per week.

Cheers

Anne