Brief Answer:
The risk of Pulmonary hypertension is almost equal to normal births

Detailed Answer:
Hello thanks for asking from HCM

You are 37 weeks and have GAD (generalised anxiety disorder) since last 10 years. You are currently taking 50 mg Sertraline tapered from 100 mg per day.

If we consider pulmonary hypertension to new born in normal pregnancy the risk is about 1.2-1.3 per 1000 births. The risk increased if woman is smoker or have poor health or taking multiple drugs.

A lot of research studies were done on pregnant females who were on SSRIs (or Sertraline) and the risk came near about 2.7-3 per 1000 children. Though it appears that risk increases to two fold but there were a lot of limitations in that studies and the sample size of these studies were low.

Most of these studies were done of small populations and were retrospective studies based on statistical data obtained from population registers or from other studies. Prospective studies are very limited and found nothing. Associated risk factor like maternal smoking, clinical condition of mother, other drug uses etc were not taken into account. So though some studies denote increased risk of Pulmonary hypertension to child but the risk is practically insignificant and is almost equal to children born to healthy mothers. So there is no need to panic for that. I have given Sertraline to a number of patients in my clinic and I didn't came across any incidence of pulmonary hypertension in children born to them.

So please you have already reduced the doses and now about to deliver in coming weeks so please don't worry about anything. As per my opinion the risk is almost equal to normal females. (I have used some medical words in answer just to reassure you and to understand you better about the research studies available)

Thanks, hope this reduces your anxiety. Don't hesitate to ask again for more doubts

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Brief Answer:
Xanax is safe to use if taken with prescription

Detailed Answer:
Hello again

As per my opinion increasing the dose of Sertraline will do nothing as its symptomatic anxiety. Taking Xanax on SoS basis is a good option and this will help to reduce symptoms. Take the medicines in consultation with your doctor. If C-section has been planned tell the doctor about your drugs. Xanax can be taken safely in low doses in pregnancy.

Thanks

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Brief Answer:
Keep the doses in lower range

Detailed Answer:
Hello again

Keep the doses in lower range and that will reduce anxiety. Doses of 025-0.5 are totally safe and no need to worry. Apart from cognitive therapy, Behaviour therapy with relaxation exercises will reduce anxiety. Try Yoga to keep your anxiety away.

Thanks, wish you a good health.

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Brief Answer:
The risk is almost same in both cases

Detailed Answer:
Hello again

Yes SSRIs have nothing to do and the risk if almost equal to the females who were not taking SSRIs or those who took late. The various studies have many confounding factors so cant be taken to measure the risk. The risk is almost same as the risk in females who are not taking the drug.

So don't take stress for that.

Thanks, hope this reassures you.

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Brief Answer:
Zoloft is relatively more safe than Cipralex

Detailed Answer:
Hello thanks for asking again

First of all I would like to tell you that there is no need to feel sorry for a lot of questions. Its my duty to answer all your questions and to relieve your anxiety. No need to feel bad for that.

Sertraline (Zoloft) and Escitalopram (Cipralex) both are SSRI drugs but if we consider overall safety in pregnancy then Zoloft is considered as safest SSRI drug in pregnancy as per guidelines.

- Once you give birth and plan breastfeeding you can increase the doses again to 100 mg per day without any fear. SSRIs are relatively safer drug in breast feeding. But if your anxiety and panic came under control with low doses then there is no need to increase drug.

- As Sertraline is relatively safer so as per my opinion you should stick to Zoloft and don't think to shift to Cipralex. Zoloft is better tolerated than Cipralex in pregnancy.

- Cipralex 20 mg was a high dose and this will not be safe to take at present time. You can shift to the drug after delivering baby. No risk at that time.

Make any change in your prescription by consulting your doctor only.

Thanks, hope this helps you. Please don't hesitate to ask again for more doubts.

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Brief Answer:
Its safe to shift from Escitalopram to Sertraline

Detailed Answer:
Hello again

As Zoloft and Cipralex from same class of drugs i.e. SSRIs so this was the reason that your new psychiatrist advised to reduce the doses of Cipralex rapidly while in the same time increased the doses of Zoloft. This cross tapering doesn't cause withdrawal symptoms and is safe method.

No changing in medicine from Cipralex to Zoloft is not dangerous, in fact its safe.

Your baby is good on scans so don't worry about unnecessary things. Try to keep yourself happy and keep smile on your face, this will improve growth of developing baby.

Thanks.

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Brief Answer:
Wish you a good health

Detailed Answer:
Thanks for your compliments.

I wish you and your baby a good health. Take care

Thanks, if you have any doubts in future you can ask again through my profile by clicking "ask me a question"

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=65151

Thanks

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Brief Answer:
Yes, dose should not be taken in night before surgery.

Detailed Answer:
Hello,

Thanks for asking again.

Yes, the dose of Sertaline should be stopped at least one day before surgery. In usual practice, if a patient is taking high doses then the doses are stopped for at least 3 days before surgery. As C-section is usually done under spinal or epidural anaesthesia so there will be no effect of drug on surgery.

You should avoid using Xanax before surgery but 0.25 mg doses will do good. Before admitting for C-section explain about your drugs intake.

Both drugs will not have any bad effect on your surgery.

All the best for your surgery and I wish you and your baby a good health.

Thanks, don't take undue tension about your drugs and surgery. C-section is a short and safe procedure and you will not have any anxiety during surgery.

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