Posted by Laurie Beth on April 5, 2006, at 14:15:15
In reply to Re: zoloft sadness, happiness, rapture, oxytocin, posted by River1924 on April 4, 2006, at 19:56:01
I'm a nursing mom with post-partum depression. I felt great during this pregnancy. True, I was on ~50 mg. of Zoloft throughout (I had continued on Zoloft after a prior PPD episode). But it seemed to me that the pregnancy hormones themselves were a big factor in my feeling very good. (After several years of secondary infertility treatment, I was thrilled to beat the odds and get pregnant at age 41, so that might have something to do with it too, but I also felt better in the second and third trimesters than in the first, so I tend to think that the high levels of estrogen and progesterone, perhaps in combination with the Zoloft, were making me feel good and think clearly.) At birth, we raised my Zoloft dose to 100 mg. prophylactically, in one day. Possibly that had something to do with what happened next, but note that I had been on 200 - 300 mg. of Zoloft between pregnancies, with some blunting of affect and some decrease in motivation, but not so much that I chose to go off at the time (even after I finally figured out that Zoloft was implicated in thesse reactions; no one told me that; like many here, I had to figure it out on my own before I saw it confirmed here). I nursed this baby, as I did my first baby, and continued to feel good for the first 2 months after she was born, and thought that Zoloft and many other precautions had saved me from a second episode of PPD. Then, when she started sleeping through the night at 2 months, I started to feel more anxious, perfectionistic, irritable, and apathetic, started having some insomnia, started having trouble making decisions, and started having problems with cognitive slowing, memory, and even clumsiness. We raised the dose to 200 mg., and the anxiety went away, replaced by increased cognitive slowing, incredible sleepiness and, when I wasn't so sleepy, incredible apathy and anhedonia. I was still nursing.
So why did I now feel SOOOO bad on 100 - 200 mg. of Zoloft, when I had felt only some apathy and emotional blunting on 200 mg. - 300 mg. before? Maybe it was just Zoloft poop-out, but I wonder about the role of of the hormones involved, or of the sudden change in hormones - from estrogen and progesterone in pregnancy, to prolactin and oxytocin after birth, and then, at 2 months, presumably to less, but still significant levels prolactin and oxytocin, as I continued to nurse the baby, but no longer during the night.
I often try to puzzle out these connections. But I can't figure it out in any satisfying way.
I have since gone off Zoloft completely (very slow taper), and started being able to cry again (thank goodness), but I still had significant apathy, anhedonia, and irritability. Two months after taking my last Zoloft pill, I started on Wellbutrin, and am now at 600 mg. and doing better on all fronts - not great, but better. I am still nursing, but my baby is now 15 months, and the birth is 15 months past, so I'm not sure how much of the change is attributable to the Wellbutrin, and how much is attributable to just time, or to being the mother of a toddler instead of a baby now.
My pdoc said that I'd probably be fine again if we could induce a "false pregnancy" hormone state in me. I speculated to him that my brain just doesn't seem to like prolactin (because I had PPD both times, while nursing my daughters), but he said if that, if anything, the emotional and mental difficulties probably had more to do with oxytocin (but he didn't elaborate).
So, for me, it doesn't seem as simple as oxytocin good / serotonin bad. Though I do think that rapid CHANGES in hormones (due to nursing, and due to probable perimenopause) might be a big part of the problems.
Speculation welcome....
-Laurie
poster:Laurie Beth
thread:628113
URL: http://www.dr-bob.org/babble/20060403/msgs/629280.html