Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
Coming off Postpartum Depression Medication | | | QUESTION | | | Dear Dr. Greenfield,
I have a question regarding postpartum depression medication and treatment. I currently have an eleven-month-old daughter, and have been on Zoloft since February of this year. I went through an extremely difficult time after I had the baby with severe depression, anxiety attacks, loss of weight, etc. The Zoloft helped tremendously, and it was definitely the right course to take. I am thinking about having another child, and just recently weaned myself off of Zoloft. I had been taking 150 milligrams, and I reduced the dosage down by 25 milligrams each week. As of a few days ago, I am completely off.
Can someone please tell me what the withdrawal symptoms are, if any? I have been feeling somewhat depressed, having dizzy periods, becoming overheated, and at times, feeling lightheaded. Are these symptoms typical, or should I be concerned? Believe me, I have no desire whatsoever to go back to the place where I have been.— Barbara in Marietta, GA | | | ANSWER |
November 6, 2001 | | | Dear Barbara,
Dizziness, nausea, fatigue, headache, problems with balance, shock-like sensations, and tingling or numbness have all been reported by people coming off of anti-depressant medications. Some patients describe the dizziness as feeling like they are swimming or spaced-out, and it may be made worse with movement. These symptoms can usually be avoided by decreasing the dose over weeks--but some people get these problems even if they withdraw slowly, as it sounds like you did. I imagine also that it might be making you anxious to come off of this medication that gave you such relief after so much suffering, and I suppose some of the symptoms could be related to those anxious feelings.
The good news is physical symptoms of withdrawal do not indicate that the depression is going to recur--these events are unrelated. However, if it does turn out that you still need the medication in order to manage on a daily basis, there is pretty good evidence for the safety of fluoxetine (Prozac) in pregnancy and some evidence of safety for sertraline (Zoloft). It would be reasonable to restart it in the second trimester, after the baby's organs have formed, if it seems necessary.
I'm glad that you were able to get help when you were suffering with postpartum depression. I hope that publishing your letter will give others hope that they too can eventually get relief of the pain of postpartum depression. Take care, and thanks for your openness and your question!— by Marjorie Greenfield, M.D. |
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