Question:
I have panic disorder and agoraphobia,and take paxill for it. Today i found
out that I'm pregnant so I will have to stop taking the paxill. I'm really
scared that without the paxill I will go crazy, because even with the paxill I
still have severe panic attacks. When I had my first child I didn't have this
disorder, and knowing the pain you go through in labor I'm really scared I'm
going to panic and quit breathing or even die. I don't have insurance so I go
to the free clinic and you always see a different person there every time you
go...never the same doctor. I'm so afraid when it comes time to have the baby,
the doctor there will not no about my problem. Well I know it will be on my
chart, but I'm afraid he might not understand just how severe my attacks are!
I'm just really scared about the whole pregnancy because I won't be able to
take my nerve pills if I need to,or the paxill. I don't take the nerve pills
very often anyway because just knowing they are there makes me feel better! I'm
having anxiety right never even thinking about the situation! Don't get me
wrong I am really excited about having another baby, I just wish I didn't have
to go through the pregnancy and labor! If anyone has any advice PLEASE write
me! I really need to heart from you!
Answer:
Whoa! Hold up for a minute! Didn't you say that you found out that you're
pregnant? Does that mean that in about 6 more months you'll deliver? If this
is true, it's to early to worry about the pain of delivery. Your doctor/s will
work with you on the anxiety. Like I said to a previous poster on this very
topic, I was told to stop my meds, too, by my OB/Gyn. My pdoc was in
agreement. My pdoc said we'll watch you, and it will get to the point where
we'll see if being on the med is better for you. So, in other words, I'd have
to see if I could "stand" being off the med. If I could not, they were going
to work with me on the medication (My OB/Gyn was willing to let my pdoc make
this decision.).
I have had one normal delivery, and yes it was painful. The doctors had no
problem with providing Demerol for pain once I had gotten dilated to a certain
point. Also, the doctors may give you an epidural if you wish. It's totally
up to you. You may find that you'll get to the 9th month and want to go
natural. Who knows?
My last two pregnancies were delivered by c-sections. I felt no pain during
the deliveries because I was "blocked". Although, I still panicked; but once
those babies were out...the doctors put me out!
I keep thinking that my twins were born a day later than they really were
because I didn't really wake up until the next day.
What I am trying to say is talk to your doctors, make sure that all of them are
aware that you have panic disorder, make them understand what you would like to
have done during your pregnancy. If they believe that it is in your best
interest, I'm sure they'll work with you.
My cousin was taking Paxil for PD when she got pregnant, but she didn't relapse
when she stopped the Paxil. Apparently there is something about the funky
hormone things that happen to women when pregnant that prevents panic,
depression, etc.
My recommendation would be to find a psychopharmacologist who specializes in
treating women, or who is experienced with the problems of psychopharmacology
in pregnancy. Such people exist: call the psych department of a
university-affiliated hospital and ask if there is one there. That person
should be able to help you decide how to deal with this tricky problem. One
thing is that the greatest risk to the developing fetus from drugs is in the
1st trimester - so you might be able to restart the Paxil while still pregnant.
Or, since SSRIs are so safe, you might not have to stop at all.
