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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Phobia Of Labor And Anxiety During Pregnancy

I ve been seeing my psychiatrist and taking Prozac 60mg, subutex 4 or 8mg/day, adderall 60mg, and klonopin half of 2mg every night to help me go to sleep. I ve been on these meds for about 3 years and I am now 10 weeks pregnant. My Dr cut the dosages in half for every medication, but didn t write a script for klonopin and told me to ween of whatever I have left. I tried to get used to taking the new dosages of my meds for about 2 weeks but was feeling very depressed. So I went back to taking my regular dose of every medication plus I m taking half of the 2mg every night before bed. I also was diagnosed with bad anxiety when I was a teen and had panic attacks until I started taking the meds, it helped me calm down. I have a very high tolerance. My body is used to the subutex and adderall and I don t get the same feeling I used to when I first started taking them. It helps me with my add and concentration and the subutex helps my cravings for opiates since I was addicted to taking prescribed pain medicine, like 30mg roxys. Sorry I forget the actual name but that was a favorite of mine. I m so scared as to what s going to happen. I feel very selfish and don t know if I should keep this baby or not. I ve also had 2 abortions a few years back. Both were done years apart from each other. I really wanted to lay everything out to hopefully get a positive answer because all I think about is always negative thoughts. I also have had a phobia of labor since I was ateen as well. I m petrified of the pain I m going to experience and truthfully thinking more towards abortion. God, I sound terrible. I don t want to be judged, I just need an honest answer. Please help me. Thank you for taking the time to read this long question and details about me. Hope to hear from someone very soon.
Fri, 31 Oct 2014
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Psychiatrist,  's  Response
Hello Welcome to HCM

You were taking 60 mg Fluoxetine, 4-8 mg Buprenorphine (subutex), Adderall and about 1 mg of clonazepam per day. The doctor reduced the doses as you are 10 weeks pregnant. See abrupt decrease in doses of medicines may be a reason behind the rebound increase in anxiety. Over all fluoxetine is safe to use in pregnancy if we consider the risk-benefit ratio. This drug can effectively control depressive and anxiety symptoms. Clonazepam is an benzodiazepine and it has high dependence potential. It can cause dependence in foetus also and may cause various congenital anomalies. As currently you are in first trimester so most of drugs should be used in low possible doses and this is the reason that your doses are reduced. Try psychological methods to get rid of anxiety and panic attacks, consult a psychologist for better treatment. Don't think negatively and abortion is not a solution as this will further increase depression and psychological trauma and guilt feeling. Low dose benzodiazepines can be used for severe panic attacks in pregnancy but on SOS basis only.

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Suggest Treatment For Phobia Of Labor And Anxiety During Pregnancy

Hello Welcome to HCM You were taking 60 mg Fluoxetine, 4-8 mg Buprenorphine (subutex), Adderall and about 1 mg of clonazepam per day. The doctor reduced the doses as you are 10 weeks pregnant. See abrupt decrease in doses of medicines may be a reason behind the rebound increase in anxiety. Over all fluoxetine is safe to use in pregnancy if we consider the risk-benefit ratio. This drug can effectively control depressive and anxiety symptoms. Clonazepam is an benzodiazepine and it has high dependence potential. It can cause dependence in foetus also and may cause various congenital anomalies. As currently you are in first trimester so most of drugs should be used in low possible doses and this is the reason that your doses are reduced. Try psychological methods to get rid of anxiety and panic attacks, consult a psychologist for better treatment. Don t think negatively and abortion is not a solution as this will further increase depression and psychological trauma and guilt feeling. Low dose benzodiazepines can be used for severe panic attacks in pregnancy but on SOS basis only. Thanks, hope this helps you. Wish you a good health.