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Dr. Pfeiffer
Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5986
Experience:  Ob/Gyn Doctor
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Can I get pregnant on Paxil CR? I have hard a time switching

Resolved Question:

Can I get pregnant on Paxil CR? I have hard a time switching from paxil cr to something else. I have tried slow tapering, switching to zoloft. It is flustrating. Any ideas?
Submitted: 1 year ago.
Category: OB GYN
Expert:  Dr. Pfeiffer replied 1 year ago.

Dr. Pfeiffer :

hello

Dr. Pfeiffer :

first things first.

Customer:

hi


 


 

Dr. Pfeiffer :

ideally...getting off the ssri medications would be best as they do increase the risk of birth defects.

Dr. Pfeiffer :

and..paxil, in particular, has been associated with heart problems in the baby.

Dr. Pfeiffer :

do you take it for depression or anxiety?

Customer:

anxiety. I have been on it since I was 17. The worse thing about being off Paxil is that I can't function. I am a nurse and can't work and get nauseous easy and irritable.


 

Dr. Pfeiffer :

ok...I understand.

Dr. Pfeiffer :

have you taken any other antianxiety medications outside of the SSRI?

Customer:

no.

Customer:

The only other med I am on is inderal LA for Palp/SVT/Anxiety

Customer:

Is Inderal Ok?

Dr. Pfeiffer :

ok..

Customer:

oh i take it back...when I was 17 I tried Klonopin and xanax....but never after that

Dr. Pfeiffer :

are the palpitations due to anxiety or an underlying problem..ie wpw

Dr. Pfeiffer :

ok..did either of those work?

Customer:

not entirely....thats why I went on paxil. It was a Class B then

Dr. Pfeiffer :

right...that changed a few years ago.

Dr. Pfeiffer :

in general, beta blockers are fine in pregnancy except for atenalol, which can cause growth restriction.

Customer:

well at least I don't have to worry about inderal.

Dr. Pfeiffer :

right.

Dr. Pfeiffer :

have you tried to change under the direction of your psychiatrist or on your own?

Dr. Pfeiffer :

have you tried to get off of it?

Customer:

both.

Dr. Pfeiffer :

and just doesn't work?

Customer:

yep...I tried cross tapering to zoloft.........that was crazy....had to take a month off of work. Then I slowed tapered down and got from 25 mg to 15 mg and crashed.

Dr. Pfeiffer :

yikes...got it.

Customer:

Can I get pregnant and then switch? Only because I have PCOS and I don't know if and when I will become pregnant? I mean is this a feasible idea to bring up to the OB?

Dr. Pfeiffer :

have you ever tried buspar?

Customer:

no...

Dr. Pfeiffer :

well...like I was mentioning, it would be best to not be on it when you do get pregnant.

Dr. Pfeiffer :

and perhaps you could try buspar, which is what I used for anxiety in pregnancy.

Dr. Pfeiffer :

with the ultimate decision...in the end, that if the only way you function in life is on the Paxil CR...you may have to decide to continue to take the medication and watch the baby closely for signs of birth defects.

Dr. Pfeiffer :

we're not taking big numbers here...ballpark of 2-4%, which is an increase over the standard 1-2% seen on average.

Customer:

I see. okay. Am I allowed to ask you a question that I already asked other obgyn on a board for a second opinion?

Dr. Pfeiffer :

sure

Customer:

can i give you my ultrasound report?


 

Dr. Pfeiffer :

sure

Customer:

The uterus is retroverted in position measuring 7.76 X 3.45 X 5.48 cm. Images of the endometrium are not available on the present examination. The left ovary measures 2.53 X 2.53 X 2.3 cm. In the right adnexal region, there is noted multiple closely adjacent cysts or multiloculated multiseptated cystic structure overall size measuring 5.98 X 5.62 X 5.59 cm. The largest cyst measures 4.04 X 3.35 X 3.44 cm. This may represent large right ovary containing multiple cysts, the possibility of multiseptated, multiloculated cystic lesion cannot be entirely excluded. Endovaginal ultrasound examination will be helpful for further evaluation. There is no evidence of free fluid in the pelvis. IMPRESSION: There is multiple closely adjacent cysts or multiloculated, multiseptated cystic structures in the right adnexal region, which may represent right ovary containing multiple cysts. The possiblity of multiloculated, multiseptated cystic lesion related to the right ovary cannot be entirely excluded. Endovaginal ultasound exam will be helpful for further evaluation.

Dr. Pfeiffer :

ok..normal except for the right ovary.

Customer:

So what is going on?

Dr. Pfeiffer :

I'd repeat the ultrasound with a trans vaginal ultrasound to see if they can determine if this is multiple cysts or a multiloculated cyst.

Dr. Pfeiffer :

if it's multiple cysts it could be pcos.

Customer:

difference?

Customer:

well I have dx pcos

Customer:

since 21

Dr. Pfeiffer :

if it's multiloculated it could be something more serious that requires a surgical evaluation.

Customer:

could it be cancer?

Dr. Pfeiffer :

unlikely, but cysts with a multiloculated appearance (complex) can be.

Dr. Pfeiffer :

but again, unlikely at your age, but something I'd clarify with a repeat ultrasound.

Customer:

Well it was a pelvic and not transvag so they couldn't tell the difference you think?

Dr. Pfeiffer :

the report suggests it was an abdominal ultrasound rather than a transvaginal ultrasound

Customer:

right..so they can't see as well...right?

Dr. Pfeiffer :

right

Dr. Pfeiffer :

less tissue to go through vaginally

Customer:

okay...Well thank you! I hope it turns out good. I hope the % chances is low!!

Dr. Pfeiffer :

yes..it is low.

Dr. Pfeiffer :

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Thank you.
Dr. Pfeiffer

Customer:

Thank you.

Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5986
Experience: Ob/Gyn Doctor
Dr. Pfeiffer and other OB GYN Specialists are ready to help you
Customer: replied 1 year ago.

So...I ended up getting a transvag....and it showed the Right ovary is 3.61X3.54X2.47 and showed I had a 7 mm left ovarian cyst and a 1.4 cm Right ovarian cyst. Wierd how it was so different between the two. The doctor said he is not concerned with this. :) What do you think?

Expert:  Dr. Pfeiffer replied 1 year ago.

yes...

not concerning at all.

the ovaries will make multiple follicles each cycle with one becoming a dominant follicle...and that's the one that ovulates.

the others usually just go away..

so that's how it happens.

Dr. Pfeiffer

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