My
healthcare provider has prescribed some medications that I take
regularly. I’m not sure if I can take them during pregnancy. Should I
stop taking them now or wait to talk about it at my first prenatal
visit next week?
Call your healthcare
provider’s office and talk to the nurse. Some medications, such as
thyroid medicine, are very important during pregnancy. Stopping them
could cause problems.
Antidepressants
If you’re being treated for depression
when you become pregnant, it’s important to continue treatment.
Treating depression during pregnancy is as important as treating any
other problem.
If you take antidepressants, don’t stop
unless advised to do so by your healthcare provider. There is a higher
risk in abruptly stopping antidepressants. In addition, studies show
that up to 70% of women who take antidepressants during pregnancy
relapse into depression if they stop their medication.
Depression can be difficult to manage
without using drug therapy. Medication you take is probably necessary
for your good health and the good health of your baby. Left untreated,
depression can contribute to premature birth, IUGR, low birthweight,
stillbirth and low Apgar scores in baby after birth.
Stopping your medication can raise your
stress hormones, which increases your risks of complications and
problems. The risks to you and your baby may be greater than your risk
of taking antidepressants.
There may be a very
small increased risk of birth defects with some medications taken
during the first trimester. You may benefit by switching to an
antidepressant that has been shown to be relatively safe during
pregnancy, including fluoxetine (Prozac), citalopram and escitalopram
(Lexapro). Pregnancy may affect your body’s ability to metabolize
lithium. Talk to your healthcare provider as soon as you confirm your
pregnancy.
If you take an SSRI, your dose may need
to be increased during the third trimester to maintain your normal
mood. There may be a small increased risk of persistent pulmonary
hypertension in babies born to women who take SSRI antidepressants
after 20 weeks of pregnancy.
There is continued concern about the
safety of Paxil during pregnancy. Research suggests exposure to the
drug in the first trimester of pregnancy may be associated with an
increased risk of heart birth defects. If you’re pregnant, do not stop taking your antidepressant medication without first consulting your healthcare provider.
Hormone-Replacement Therapy (HRT)
Today, the average age of menopause is
51. At menopause, you stop ovulating (necessary for conception) and
stop having periods. The change is usually gradual, occurring over
years, but it may be sudden. If you still have menstrual periods, you
can probably still get pregnant.
In the past, women didn’t start taking hormones (hormone-replacement therapy or HRT) until their periods stopped and they were certain of menopause. Today, more women start HRT at younger ages.
If you become pregnant while taking HRT,
tell your healthcare provider immediately. There are minor risks
associated with pregnancy if you have been taking female hormones.
Incontinence Medications
Incontinence may be more of a problem for women over 35. Do you take medicine to treat an overactive bladder?
The problem of overactive bladder occurs
when the brain tells nerves in the bladder there’s a need to urinate
even if the bladder isn’t full. Symptoms include going to the bathroom
more than 12 times a day, getting up two or more times at night and a
sudden, immediate need to go. You may also leak urine.
Medicines to treat the problem work by
relaxing muscles. Some commonly prescribed medications include
Ditropan, Detrol LA, Sanctura and Enablex. If you take any of these
medications, you need to talk to your healthcare provider
before pregnancy or as soon as you find out you’re pregnant. He or she
can advise you about continued use of your medicine during pregnancy.
