So today I saw my psychiatrist for the first time since going on bed rest. I made the appointment now in order to get things squared away in case I have to deal with postpartum depression (PPD), which I’m at VERY high risk for. I wanted to make sure that in case of a med switch, we had plenty of time to pull it off.
I left the appointment practically in tears.
So here’s the deal:
I’ve been on a drug called zy.prexa for the last 4 months. It was a good interim solution because it can handle high-anxiety situations as well as curb depression. Though it’s not usually prescribed for depression and anxiety, it’s known to work for people who are SSRI-resistant (or in other words people who the usual happy pills don’t work on – like me).
So I walk into the shrink’s office and pretty much the first thing I tell him is that I have GD. Immediately he says that it could very well have been caused by the zy.prexa. I knew that weight gain was a side effect (knew that all too well, thank-you-very-much), but I had no idea it could affect my blood sugar. He told me that he wanted me to stop the pill immediately, and manage through the rest of the pregnancy with the occasional xan.ax (ok during the third trimester as long as I don’t take any after week 38), and that’s it. The zy.prexa has too much potential to do harm.
He also said that he would recommend I never take the pill again because he’s afraid of the long-term risks for my health, and that it may cause diabetes for me in the long run if I continue to take it.
I have to say I was a bit relieved. I don’t regret taking the pill – it helped me keep my shit together, and if GD is a side effect of that, so be it, but I’m glad to know that there’s a chance my blood sugar will even out more now that I’m going off the pill. And there’s no way of knowing if the pill caused the GD or is just not helping a set situation. Either way I can see an upside to both having been on it, and now going off of it.
Then came the bombshell:
Shrink: “So after you give birth, I want you to breastfeed for a week, then we’ll put you back on a low dose of cym.balta”.
Me: “Ok… Wait… What do you mean breastfeed for a week?”
Shrink: “There’s not enough research out there about cym.balta. You shouldn’t breastfeed while you’re on it.”
There was a continual back-and-forth about this but basically the conclusion is this:
I can wait it out to see if PPD hits before I start taking the pill (about three weeks after giving birth), but if I do get PPD, I have no choice but to stop breastfeeding immediately because I would never risk it with cym.balta in my system. I can’t get another pill because me and SSRI’s (zo.loft, pa.xil and the like) are NOT friends at all, and zy.prexa is too big of a risk, so I’m stuck with this one form of happy pill, and I can’t do anything about it.
The fact is that there’s a pretty decent chance I’ll get PPD. I have practically every risk factor in the book between my losses and my history of depression. And if I get PPD, of course it needs to be treated, which means I won’t be able to breastfeed. So now here’s yet another thing taken away from me, and I fucking hate it.
Look – I joked that if breastfeeding doesn’t come easily to me I’ll happily use cym.balta as an excuse to stop. But I have a feeling that may not be the case. What if I love it? How can I give it up if it comes naturally to me and B5?
When I called Shmerson and told him the verdict he pointed out that these are first world problems. That six months ago I would have killed to be in a discussion about the risks of breastfeeding while on SNRI’s.
And he’s right, but right now it doesn’t make this hurt any less.
All I can do now is hope that by some miracle I don’t get PPD. But realistically I know that chances of that are close to nil.
So yes, this is a “fertile world problem”. But that doesn’t mean I’m not going to cry my eyes out over it. So excuse me while I go do that.