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Antidepressants

Disclaimer:

This publication is based on a Mind UK publication and the original version may be found here: https://www.mind.org.uk/information-support/a-z-mental-health/

Thank you to Mind UK for sharing their valuable content with us. Content included in Mental Health A-Z is made available free of charge and does not form part of any commercial activity. The adaptation has been done independently by Mind HK and is intended for general information purposes only.

Antidepressants during pregnancy and breastfeeding

This page covers: 

  • What are the risks and benefits of taking antidepressants while pregnant or breastfeeding?
  • What can I do to feel more in control? 
  • Further support during pregnancy and breastfeeding

“I developed severe postnatal depression and OCD just three days after the birth of my daughter. I  was non-functioning, I couldn’t even leave the house and was suicidal… [My antidepressant] really  helped, and gave me the crutch I needed to function again. I really feel like it saved my life.”

What are the risks and benefits of taking antidepressants while pregnant or breastfeeding? 

There are some risks to taking antidepressants during pregnancy or while breastfeeding. These  include the following: 

  • Possible birth defects. There is evidence that taking SSRIs early in pregnancy slightly  increases the risk of your baby developing heart defects, spina bifida or cleft lip. 
  • Increased risk of miscarriage and premature birth. 
  • Withdrawal symptoms in your newborn baby. Taking any antidepressant in late pregnancy  has the risk that your newborn baby will experience withdrawal symptoms. These symptoms  include:

– With SSRIs and SNRIs: jitteriness, poor muscle tone, not being able to cry loudly,  difficulty breathing, low blood sugar (which can cause fits), and high blood pressure  in the lungs.

– With tricyclics: fast heartbeat, irritability, muscle spasms, restlessness, sleeplessness,  fever and fits.

  • All pregnancy-related risks are likely to be higher when taking antidepressants during the  first three months or last few weeks of your pregnancy. 
  • If you are breastfeeding, antidepressants can be passed to your baby through your breast  milk. It is possible that the levels could become high enough for your baby to experience  side effects from the medication. 
  • If you wish to breastfeed, you should avoid taking doxepin (Sinequan). 
  • Drugs are not usually clinically tested on anyone who is pregnant. There is not much  evidence around how safe it is to take antidepressants during pregnancy. Newer drugs carry  a higher ‘unknown’ risk than drugs that have been around longer. This is because scientists  have had less time to gather evidence about them. 

There may also be benefits to taking antidepressants during this time: 

  • You might already be taking antidepressants when you become pregnant. You may feel  concerned about becoming unwell or unable to cope if you stop taking antidepressants. This  may mean you decide that the best thing for you and your baby is to continue taking them,  so you are well enough to care for your baby. 
  • Or you may be offered antidepressants to help treat a problem you developed during  pregnancy or after giving birth, such as postnatal or antenatal depression.

Your doctor can help you balance the possible risks to your baby against the benefits of taking your  medication. This is to help you come to your own decision about what’s best for you. But it is  understandable if you feel unsure about this. You might find it helpful to seek further support during  this time. 

“When I got pregnant I was terrified of not being able to look after a child in the mental state I was  in. So I tried [antidepressants]. I couldn’t function anywhere near as well till I had them.”

What can I do to feel more in control? 

Being pregnant can sometimes feel like you’re giving up control of your own body. This can be  stressful, but there are lots of positive steps you can take: 

  • Planning your pregnancy gives you more options early on. But it is also a common  experience to find out you’re pregnant without planning it. Whatever your situation, it’s  important to remember that you have the same rights as everyone else. This includes the  right to choose whether or not to take medication, and to have your say in decisions about  your treatment. 
  • Talk to a healthcare professional as early on as you can. This could be with your doctor or  midwife, or a mental health specialist. The earlier you start talking to someone about your treatment options, the more in control you’re likely to feel. For planned pregnancies, this is as soon as  you decide you want to start trying to get pregnant. For unplanned pregnancies, this is as  soon as you think you might be pregnant. 
  • Seek further support, to talk through your options and decide what’s right for you. 
  • If you decide to stay on your medication, ask your doctor how you can reduce any potential risks. For example, you may be able to manage your symptoms more effectively on a reduced  dose. 
  • If you decide to come off your medication, make sure you do it safely. See our pages on coming off medication for more information. 

Further support during pregnancy and breastfeeding 

Coming to a decision you feel comfortable with about what’s right for you and your baby can be  difficult. You might find it helpful to explore these options for extra support: 

  • Talk to someone you trust. It can help to talk through your feelings with someone you trust, such as a partner or close friend. 
  • Midwife appointments. If you are under the care of a midwife, you can talk to them about how you’re feeling throughout  your pregnancy. They can also help make sure you receive plenty of support from your health visitor after you give birth. Your doctor should be in touch with your midwife and antenatal team throughout  your pregnancy. 
  • Perinatal mental health services. These services offer support to help you stay well during  your pregnancy. You can be referred to these services by other professionals involved in  your care, such as your doctor. 
  • Online peer support. It can be helpful to talk to other people who’ve had similar experiences  to yours. 
  • Specialist organisations. Hong Kong organizations:
    – Hospital Authority Mental Health Direct (24 Hours) 2466 7350
    -The Samaritan Befrienders Hong Kong (Chinese hotline) 2389 2222
    -The Samaritans (Multilingual hotline): 2896 0000
    -Family Health Service Breastfeeding Hotline 3618 7450
    – Other breastfeeding hotlines
    – Family Planning Association of Hong Kong

You might also find it helpful to read our pages on parenting with a mental health problem. These  pages include information on taking care of yourself, looking after your children, and other kinds of support available to parents. Our information on perinatal mental health problems may also help.

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What is iACT Service?

Improving Access to Community Therapies (iACT®) is one of the services from Mind HK. Trained Wellbeing Practitioners will offer initial assessment and early intervention for people dealing with mild to moderate symptoms of depression, anxiety, or other emotional difficulties.

 

The service includes 6-8 sessions of low-intensity psychological support, the flexibility of the service allows individuals to receive free and timely support when needed.

If you’re aged between 18 – 65 and are facing some emotional challenges, we would like to invite you to take an online assessment for us to gain a better understanding of your current emotional struggle.

 

If you’re eligible, we’ll get you connected with a Wellbeing Practitioner within two weeks to sort out the next steps.

The service runs for about 3 months and includes 6-8 support sessions, tailored to your needs.

 

We encourage you to attend all sessions and actively practice the tips and exercises provided by your Wellbeing Practitioner.

We take your privacy seriously. Your chats with the Wellbeing Practitioner are confidential.

 

We won’t share any of your info unless you’ve provided consent or if there are risks detected.

This programme isn’t suitable for people facing emergencies, major setbacks, or those diagnosed with serious or complex mental health conditions.

 

If you’re having thoughts of suicide or self-harm, this programme might not meet your needs, so please seek help right away. You can check out Mind HK’s “Find Help Now” page for immediate information and services.

Most of our Wellbeing Practitioners have backgrounds in psychology or counselling and are passionate about mental health. They’ve gone through about 140 hours of intensive training and completed at least 120 hours of supervised clinical practice over 9 months to ensure the quality of service.

 

They’re trained by accredited local experts in the mental health field, including clinical psychologists, counselling psychologists, counsellors, and psychiatrists. Plus, we regularly check how effective our services are. All service outputs and performances are subject to consistent monitoring.

Who is suitable for participating in this programme?

This programme welcomes anyone between the ages of 18 and 65 who may be feeling lost or facing emotional difficulties. Please note that this programme is not suitable for individuals diagnosed with severe or complex mental health conditions.

This programme is not suitable for individuals diagnosed with severe or complex mental health conditions, but suitable for those who experience mild to severe moderate anxiety, mild to moderate depression, or other emotional challenges. If you are currently experiencing a major setback or even having thoughts of suicide or self-harm, please visit the “Find Help Now” page on our Mind HK’s website for immediate information and services.

After signing up, our Wellbeing Practitioner will contact you within two weeks to schedule a convenient time for a 45-minute conversation, either via video or phone call, according to your preference. During the conversation, the Wellbeing Practitioner will understand your current situation and help you gain a better understanding of your emotional state based on the questionnaire you filled out during application. Additionally, they will provide recommendations for appropriate community resources based on your needs, helping you take an important first step in taking care of your mental health.

Although the intervention procedure is mostly standardised, Wellbeing Practitioners will work flexibly with clients to address individual presenting problems and unique characteristics.

Our Wellbeing Practitioners are trained to support people who experience mild to moderate mental health difficulties primarily. This programme is not suitable for the situations mentioned above. If you are currently experiencing a major setback or even having thoughts of suicide or self-harm, please visit the “Find Help Now” page on our Mind HK’s website for immediate information and services.

Your conversations with the Wellbeing Practitioner are absolutely confidential. Any information about you will not be shared with anyone without your consent unless you or others are at immediate risk or the Wellbeing Practitioner has reason to believe that you may be in imminent danger.
Supervisors will monitor trainees’ development throughout the placement to ensure that they are meeting the required level of competency to pass the training course at the end of the placement.

Yes, it is necessary to book an appointment in advance by filling out the form. Additionally, you can select one of the five stores yourself. We will allocate clients to different Wellbeing Practitioners based on their chosen location.

Before having the conversation, we will ask you to fill out a basic questionnaire for preliminary screening assessment. This screening process aims to ensure that the training received by the Wellbeing Practitioners is sufficient to meet the needs of the individuals receiving the service. If it is determined after the screening assessment that the service is not suitable for you, Mind HK will provide alternative recommendations to ensure your safety and support.

For adults who are suitable for this service, all Wellbeing Practitioners have received training on how to identify and respond to safety and risk issues. If you have any concerns about the support process, the Wellbeing Practitioners have appropriate measures in place and will develop response plans based on the urgency of the situation. They can also access support from clinical practitioners from Mind HK or participating organisations.

What private training does Mind HK provide?

Mind HK provides 4 themes of mental health training, including: Supporting Self, Supporting Others, Family Wellbeing and DEI (Diversity, Equity and Inclusion).

 

Check out the brochure here for more information.

Mind HK provides a wide range of standardised mental health training, which can be tailored to different circumstances. Chat with our team to explore more! 

Our trainers come from a diverse, accredited pool of clinically experienced professionals. Check out our trainers’ biographies here.

Yes, the Mental Health First Aid class of Mind HK is internationally accredited by the MHFA International. The content and certification is delivered by trainers certified from the Mental Health Association of Hong Kong. You can find out our trainers accreditation here.

We are here to support your mental health education journey! Reach out to us and chat with our team.

Antidepressants during pregnancy and breastfeeding

Antidepressants during pregnancy and breastfeeding

This page covers: 

  • What are the risks and benefits of taking antidepressants while pregnant or breastfeeding?
  • What can I do to feel more in control? 
  • Further support during pregnancy and breastfeeding

"I developed severe postnatal depression and OCD just three days after the birth of my daughter. I  was non-functioning, I couldn't even leave the house and was suicidal... [My antidepressant] really  helped, and gave me the crutch I needed to function again. I really feel like it saved my life."

What are the risks and benefits of taking antidepressants while pregnant or breastfeeding? 

There are some risks to taking antidepressants during pregnancy or while breastfeeding. These  include the following: 

  • Possible birth defects. There is evidence that taking SSRIs early in pregnancy slightly  increases the risk of your baby developing heart defects, spina bifida or cleft lip. 
  • Increased risk of miscarriage and premature birth. 
  • Withdrawal symptoms in your newborn baby. Taking any antidepressant in late pregnancy  has the risk that your newborn baby will experience withdrawal symptoms. These symptoms  include:

- With SSRIs and SNRIs: jitteriness, poor muscle tone, not being able to cry loudly,  difficulty breathing, low blood sugar (which can cause fits), and high blood pressure  in the lungs.

- With tricyclics: fast heartbeat, irritability, muscle spasms, restlessness, sleeplessness,  fever and fits.

  • All pregnancy-related risks are likely to be higher when taking antidepressants during the  first three months or last few weeks of your pregnancy. 
  • If you are breastfeeding, antidepressants can be passed to your baby through your breast  milk. It is possible that the levels could become high enough for your baby to experience  side effects from the medication. 
  • If you wish to breastfeed, you should avoid taking doxepin (Sinequan). 
  • Drugs are not usually clinically tested on anyone who is pregnant. There is not much  evidence around how safe it is to take antidepressants during pregnancy. Newer drugs carry  a higher 'unknown' risk than drugs that have been around longer. This is because scientists  have had less time to gather evidence about them. 

There may also be benefits to taking antidepressants during this time: 

  • You might already be taking antidepressants when you become pregnant. You may feel  concerned about becoming unwell or unable to cope if you stop taking antidepressants. This  may mean you decide that the best thing for you and your baby is to continue taking them,  so you are well enough to care for your baby. 
  • Or you may be offered antidepressants to help treat a problem you developed during  pregnancy or after giving birth, such as postnatal or antenatal depression.

Your doctor can help you balance the possible risks to your baby against the benefits of taking your  medication. This is to help you come to your own decision about what's best for you. But it is  understandable if you feel unsure about this. You might find it helpful to seek further support during  this time. 

"When I got pregnant I was terrified of not being able to look after a child in the mental state I was  in. So I tried [antidepressants]. I couldn't function anywhere near as well till I had them."

What can I do to feel more in control? 

Being pregnant can sometimes feel like you’re giving up control of your own body. This can be  stressful, but there are lots of positive steps you can take: 

  • Planning your pregnancy gives you more options early on. But it is also a common  experience to find out you’re pregnant without planning it. Whatever your situation, it’s  important to remember that you have the same rights as everyone else. This includes the  right to choose whether or not to take medication, and to have your say in decisions about  your treatment. 
  • Talk to a healthcare professional as early on as you can. This could be with your doctor or  midwife, or a mental health specialist. The earlier you start talking to someone about your treatment options, the more in control you're likely to feel. For planned pregnancies, this is as soon as  you decide you want to start trying to get pregnant. For unplanned pregnancies, this is as  soon as you think you might be pregnant. 
  • Seek further support, to talk through your options and decide what's right for you. 
  • If you decide to stay on your medication, ask your doctor how you can reduce any potential risks. For example, you may be able to manage your symptoms more effectively on a reduced  dose. 
  • If you decide to come off your medication, make sure you do it safely. See our pages on coming off medication for more information. 

Further support during pregnancy and breastfeeding 

Coming to a decision you feel comfortable with about what's right for you and your baby can be  difficult. You might find it helpful to explore these options for extra support: 

  • Talk to someone you trust. It can help to talk through your feelings with someone you trust, such as a partner or close friend. 
  • Midwife appointments. If you are under the care of a midwife, you can talk to them about how you're feeling throughout  your pregnancy. They can also help make sure you receive plenty of support from your health visitor after you give birth. Your doctor should be in touch with your midwife and antenatal team throughout  your pregnancy. 
  • Perinatal mental health services. These services offer support to help you stay well during  your pregnancy. You can be referred to these services by other professionals involved in  your care, such as your doctor. 
  • Online peer support. It can be helpful to talk to other people who've had similar experiences  to yours. 
  • Specialist organisations. Hong Kong organizations:
    - Hospital Authority Mental Health Direct (24 Hours) 2466 7350
    -The Samaritan Befrienders Hong Kong (Chinese hotline) 2389 2222
    -The Samaritans (Multilingual hotline): 2896 0000
    -Family Health Service Breastfeeding Hotline 3618 7450
    - Other breastfeeding hotlines
    - Family Planning Association of Hong Kong

You might also find it helpful to read our pages on parenting with a mental health problem. These  pages include information on taking care of yourself, looking after your children, and other kinds of support available to parents. Our information on perinatal mental health problems may also help.