Eight years ago, I sat on the exam table dangling my legs in fuzzy socks — waiting for my OB-GYN to confirm what I already knew: I was pregnant.
As I watched my doctor write a script for blood work and an ultrasound, I cupped my sweaty palms, rubbing them together, feeling dizzy — that familiar panicky feeling. I had to lie down. My hair splayed around me as I stared up at the white ceiling tiles with the tiny black dots.
“Are you OK, Christine?” Dr. Anna asked me. She had known me since I was 15 years old.
“I just wasn’t expecting this,” I said. “This wasn’t planned.”
“Are you still taking the Paxil?” she asked. “For anxiety?”
“Yes,” I said.
“And the Xanax?” she asked.
“Only when I need to, not a lot,” I said.
Then it hit me. Meds that had kept me healthy for the past seven years might not be allowed while I was pregnant — like sushi, caffeine, cold cuts, alcohol, and soft delicious cheeses.
“Am I supposed to stop Paxil?” I asked urgently. To me, Paxil was a magic pill that made me normal.
“No, no,” she said. “You can’t just go off that kind of medication cold turkey.”
“But is it safe?” I remember asking and searching her face for reassurance. In her white coat, she rolled over on the little stool and gave me the best answer she could: At the time, Paxil was a Class C drug, meaning moderate risk. We decided I’d stay on the drug.
Image source: Christine Coppa
New research suggests that taking antidepressants, especially SSRIs like Paxil, during the second and third trimester of pregnancy increases the risk of having a child with an autism spectrum disorder by 87 percent, compared with women who do not take medications for depression while expecting. This study did not exist in 2007 when I was pregnant. I was told by my doctor that staying on Paxil outweighed the benefits of quitting.
Lucy A. Hutner, MD, who is not associated with the study, tells Yahoo Parenting that antidepressants overall have been extensively studied in pregnancy, but analysis is limited because of a lack of randomized controlled trials in pregnant patients for ethical reasons. For example, scientists can’t tell one group of pregnant women to take drugs, and another to not take drugs, and then test their children to see how they were negatively affected.
“This is part of the reason why the results can be so confusing to patients (and doctors) who are just trying to make the best decision they can with the data that is presented to them,” says Hutner, an assistant professor of psychiatry at NYU Langone Medical Center.
For seven years, I had been taking 20 milligrams of Paxil every morning. The little yellow pill was as familiar as my multivitamin. I’d always been a nervous kid, but I had my first severe panic attack when I was 19 and a sophomore in college. I was sitting in class and then suddenly felt as if I was having a heart attack. My fingers were tingling. I couldn’t breathe, and nothing seemed real.
My doctor checked my thyroid and those blood tests came back fine, so I called it a fluke, even though the fear of having another panic attack consumed my thoughts. When I soon stopped sleeping and the panic attacks came more frequently, my doctor prescribed the SSRI, Paxil once a day, and Xanax whenever the panic was too much to handle. I was officially diagnosed with panic disorder. I began seeing a therapist and exercising more. I got better.
Today, at 35, I take Paxil and Wellbutrin, plus I have a prescription for Xanax, and probably will for life. These medications make me a better single mother and human being in general. I also work out at the gym and eat healthy. I’m just doing my best.
Panic attacks and general anxiety are not in my head. I have emotional and physical symptoms that interfere with my life. At my worst, I was just like the sad Big Pharma commercials on TV: a mess until the meds kicked in, then running on the beach, with a dog, smiling.
At 26, dealing with an unplanned pregnancy — alone — going off the meds that kept me even and thriving wasn’t an option. But I wasn’t naive. I needed to be as safe as possible.
In my first trimester, my doctor and I made a fast plan to taper my dose from 20 to 10 milligrams, then every other day starting in my second trimester. Xanax was off the table completely. For nine months I took my Paxil and prenatal vitamin with one swig of water.
“We know that untreated severe mental illness has its own risks in pregnancy, such as premature delivery, as well as other associated risks like less prenatal care, more cigarette smoking, increased risk of suicide, decreased use of healthy eating, decreased prenatal vitamin use, and fewer health-promoting behaviors such as exercise,” says Hutner.
While this new study that connects autism and antidepressants is likely causing pregnant women who medicate to launch into panic, it’s crucial to understand that mental illness doesn’t go away just because you’re pregnant.
“It’s a severe condition, it’s extremely prevalent outside and during pregnancy,” Dr. Anick Berard, the author of the new study and a professor of perinatal epidemiology at the University of Montreal, tells Yahoo Parenting. “Up to 15 percent of pregnant women have depression — some are treated with antidepressants, some aren’t.” But she also suggests women consider other treatment options. “For the 80 percent to 85 percent of pregnant women who are mildly to moderately depressed, there’s other treatment options than just medication. There’s exercise, there’s psychotherapy.”
In the end, my son was a healthy newborn, and today he’s a bright, athletic boy despite my Paxil use. He’s not autistic. Some of my friends who didn’t take SSRIs have children on the spectrum. There’s no one-size-fits all solution; instead, each woman should speak to her doctor to find what works for her. Because in the end, a healthy baby — and mom — is the goal.