The Hemp Connection:
prozac

Knowing that PCOS often goes unrecognized, and that PCOS research often overlooks some of the most important issues cysters deal with, I'm trying to bring research to this blog you may not find if you're using"PCOS" as your search term but which may be entirely pertinent. In this case, I want to talk about antidepressants, which are very commonly prescribed in PCOS, whether it's officially diagnosed or unrecognized.

This study was conducted because of the number of women who use antidepressants. That increases the possibility that a woman may, intentionally or not, become pregnant while taking antidepressant medications. The researchers wanted to know if fetal exposure to antidepressants may influence brain and nervous system development. This particular study was done with mice, but it was previously determined that mice and humans demonstrate similar mother-fetal transfer with the medications being evaluated.

Fluvoxamine (Luvox) had a lower rate of transfer than did fluoxetine (Prozac). More offspring died in the group using fluoxetine, and most of these deaths were due to heart failure related to cardiac defects. The researchers reported no deaths related to fluvoxamine.

In addition, the part of the brain that distributes serotonin to the rest of the brain, the raphe nucleus, did not function properly in the brains of rat pups whose mothers had been exposed to fluoxetine. Behaviorally, these rats exhibited more anxiety- and depression-related behaviors as adults than rats who had not been exposed.

So it seems that babies of moms who have depression may be set up to have the same problems when they become adults. Some of that may be genetic, but some of it may be perpetuated by the way the mother's biochemistry is treated by her caregivers.

Bottom line, if you're using antidepressants, even if you're NOT trying to become pregnant but you MIGHT become pregnant because you're sexually active, you may want to be sure that you discuss this with your physician and determine which treatment option is most appropriate.

Don't forget diet and fish oil--they can eliminate the need in many cases to even have to make this kind of decision!

Noorlander CW, Ververs FF, Nikkels PG, van Echteld CJ, Visser GH, Smidt MP. Modulation of serotonin transporter function during fetal development causes dilated heart cardiomyopathy and lifelong behavioral abnormalities. PLoS ONE. 2008 Jul 23;3(7):e2782.

The more I work in the area of fertility, the more I realize just how stressful it is to be told you are infertile and that conceiving a child will be difficult at best. It seems to me, that the unusual woman placed in this situation is the one who lives through it without experiencing any sort of depression.

Which is why this research caught my eye.

90 women diagnosed with infertility were randomly divided into 3 treatment gorups. One-third of them were given 10 sessions of behavioral therapy, including: relaxation training, and learning to eliminate negative automatic thoughts and dysfunctional attitudes. One third of the group was given 20 mg fluoxetine (Prozac) daily for 90 days. The last group did not receive any intervention.

And look at THIS! 79.3% of the women in the behavioral training group improved, compared to only 50% of those on medication. (Ten percent in the control group improved on their own.)

There are probably many reasons for these results. Here are a few that I thought of:
1. Behavioral therapy helped to extinguish the thoughts and behaviors that potentially contributed to the depression in the first place. Medication didn't.
2. When you talk to someone about how you feel, it often helps reduce the perceived magnitude of the problem. When you hold it all in, it only fuels the depression.
3. Behavioral therapy focuses you on the many things you CAN do to take care of yourself. It's an entirely different perspective than you may be getting from doctors who are telling you that you CAN'T get pregnant, you CAN'T etc., etc., etc.

Over the years in this specialty, I've seen many women externalize their depression. That is, they blame it on causes outside of themselves--"it's because I can't lose weight, it's because I can't have a baby, it's because I look like I do"…and so on. I won't argue, when depression takes its toll on your life, its consequences can fuel a vicious cycle. But to sell yourself on the belief that"if I just lose weight, if I could just have a baby, if I could just get some cosmetic surgery…" is an invitation to disaster. The line of women I've worked with who got what they thought they wanted, and still felt the same way that they did before, and who experienced major eating disorders, postpartum depression, and even suicidal thoughts on the back end, would stretch from my office to the county line.

Depression is a metabolic state, just like diabetes, just like high cholesterol, just like a skin rash. You'd never blame your rash on your relationship with your husband or convince yourself that if you could just get rid of your"muffin top" you wouldn't have diabetes…it's equally important to not make illogical leaps when it comes to depression.

What can be crucial with infertility, is treating depression at its source. Behavioral training helps to change your perception and response to events, which in turn reduces the levels of stress hormones circulating in your body. When that happens, you sleep better, you crave less carbohydrates, and the hormones you need to work in order to conceive, feel more like it's safe to come out and play.

A word about support groups. I've seen them do wonderful things, but I've also seen them focus the participants even more on the problem they have instead of on solutions for change. I was invited to attend a support group recently and it was impossible to get the participants to talk about anything other than their personal situations, and how horrible things were for them. I don't want to invalidate these feelings, but the purpose of a support group is to come away empowered, hopeful, and with an idea or two about how to make things better. So choose your support groups wisely.

If you're feeling depressed, go talk to someone about what you can do about it. Not what someone can prescribe for you, not what needs to happen in your life in order to make it go away, but what YOU can do to get back into balance.

Faramarzi M, Alipor A, Esmaelzadeh S, Kheirkhah F, Poladi K, Pash H. Treatment of depression and anxiety in infertile women: cognitive behavioral therapy versus fluoxetine. J Affect Disord. 2008 May;108(1-2):159-64.