Better Together


Updated on November 26, 2019 in Ask A Coach
3 on November 23, 2019

How will I know I’m ready to get off my medication? Is there hope that I will. Which type of brain does better with medication?
Here is my story. A little over three years ago I was pregnant with my third child. At 7 month pregnant I got sudden extreme anxiety attacks with some depression. It came out of nowhere and I had no idea what to do with it. I was a strong stickler about being anti medication, but my situation was scary and I was desperate. So I got onto zoloft/seterline. At about 9 months postpartum I started to taper extremely slowly and extremely small amounts. I was still tapering a year and a half later when I got pregnant with my 4 child. I continued to taper during pregnancy for a bit then decided to hold off on tapering.
By 4 month’s pregnant I started to experience the anxiety and depression again. I was desperate again and in search of a better way, a better doctor. Not another doctor who would simply talk to me for 10 minutes and prescribe the “best” choice of meds during pregnancy.
So I was put on a waiting list to see a perinatal mood disorders specialist. I think I waited a couple of months until I got into see her. We visited for an hour or more and I took the GenoMind test. From my results it turned out that Remeron/mirtazapine would be the best medication that would work with me.
I was only prescribed 15 grams and I am 4 months postpartum and still at that dose.

How will I know if or when I can get off medication?

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1 on November 26, 2019

Thanks for your post. What an important question. In pregnancy, the body requires higher levels of many B vitamins, including choline and folate. Low choline levels are very common in pregnancy, particularly in women with a specific genetic variant, and yet most prenatal vitamins still don’t contain any choline! Even the American Medical Association announced in 2017 that choline should be included in all prenatal vitamins, but this has not yet caught up to the marketplace. In research, women with the lowest choline levels had the highest levels of anxiety during pregnancy, while low folate levels can contribute significantly to post-partum depression.

While tapering or removing medication must always be done with the guidance and recommendation of the prescribing physician, I would strongly encourage you to see if there are underlying nutritional deficiencies (most of us have several!) that, if remedied, may make getting off medications a much easier transition and help to prevent future anxiety.

Hope that helps! -Zoe

on November 26, 2019

Thank you.
Interesting information on folate and choline. I took Garden of Life Raw prenatals during my last two pregnancies and Dr. Christopher’s Vitalerbs during my first two. I wonder about their levels of choline and folate? I had bad food aversion my whole pregnancy with my first two and just didn’t feel well. My last two pregnancies I didn’t experience extreme food aversion except when I had bad anxiety attacks followed by depression. I also have been in my 30’s with all of pregnancies, just turning 39 a month after my 4 was born. So age may play a big part as well.

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0 on November 26, 2019

Yes, unfortunately, there is no choline in the Garden of Life prenatal. You might consider a nutritional consultation to assess for deficiencies or ask your PCP to do a micronutrient panel. Strong nausea and food aversion can also be caused by B-6 deficiencies, but fortunately many women are able to reduce symptoms significantly by supplementing prior to pregnancy to get to adequate levels. Best!

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