Comment from Anonymous

I was prescribed Mirtazapine for generalized, situational, job-related anxiety by a PCP prior to conceiving my first child. I specifically mentioned wanting to start a family in the coming years, and if this would impact that endeavor medically. I was told clearly “no, Mirtazapine is completely safe for pregnancy.” I also asked about withdrawal effects as I did not want to take the medication long-term. I was also told, “you can simply cut the pill in half for a week and stop.” About a year later, in a new job and not facing any significant life stress, I decided to come off the medication and prepare for starting a family. I cut the medication down in half for months, then even further into quarters, as I was apprehensive about how it would feel to come off despite my doctor not being worried about it. I did not feel any withdrawal effects until I stopped taking medication entirely, and then endured about a year of protracted withdrawal symptoms, after a first week of nausea and vomiting. Over the course of that year lost over 20 pounds and faced appetite loss, insomnia, and extremely heightened anxiety. When inquiring with my doctor early on about my withdrawal symptoms, she stated it was likely the anxiety coming back and I should just keep taking it. Frankly, my body’s response to coming off the medication was the strongest motivation to not go back on it. It scared me. I wanted to conceive in the near future and couldn’t imagine how this would impact a pregnancy. I went on to conceive my son easily two years later. I had a healthy pregnancy, and a difficult postpartum. I was far too afraid to go on an SSRI postpartum due to my past experience. I cannot imagine enduring my withdrawal symptoms with parenting a child. I also cannot imagine what my pregnancy and child’s health would have looked like had I stayed on the medication as medically advised to do so. Interestingly, my inquiry about withdrawal from the medication and pregnancy safety were not included in the medical notes, which are still visible to me now in my patient portal. The nonchalance with which providers prescribe these highly potent psychotropic medications to young adults, expectant mothers, and postpartum mothers, is abhorrent. My story is a story of what “almost was”- but emphasizes the loneliness and isolation of dealing with these symptoms without medical help. I have lost significant trust in modern medicine and practitioners. I cannot fathom that doctors prescribe these medications to pregnant women without so much as a basic conversation about the risks and clear adverse effects. In the interest of reinstating the public’s trust in modern medicine, I strongly believe the FDA needs to require clear, accurate, and transparent warnings about the effects of SSRIs on all people, but most importantly, pregnant and postpartum women.