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Hi,

I have been taking Paxil for my anxiety, and it has severely reduced my symptoms. My boyfriend and I have been talking about having a baby. For me, in addition to all that other stuff you do when you are going to try to conceive, like think about healthy eating and vitamin supplements, the anxiety has to be taken into account as well. 

I have read that Paxil is not safe during pregnancy, and this really worries me. What could I do instead during pregnancy, to cope with panic attacks and anxiety? I also know many women with anxiety have even worse symptoms in pregnancy so this doubly worries me. 

TIA

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It sounds silly I have to admit, and I definitely felt like an id**t doing breathing exercises in therapy, but that's what they advise. Deep abdominal breathing. It seems unlikely that something like that can help, but at least it gives you something to concentrate on other than the panic attack. 

So yes, there are relaxation techniques for anxiety to get through panic attacks but if they are happening often, and you're already getting medication, I'd ask your shrink to give you tips. Reading up about it yourself is always good but they may have something to say you didn't already know about as well, right?

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I would be looking into natural relaxation techniques that can get you through anxiety attacks in this situation. Some of the antidepressants people are commonly prescribed are not proven to be safe during pregnancy, though they may still be prescribed if the anxiety is so bad that that could put you at risk. If you can do without though, that is better. 

Progressive muscle relaxation and applied relaxation both involve relaxing different muscle groups in certain orders, which gives you a focus on the very physical rather than on the mind. Deep breathing also does the same. Apart from that, regular exercise, perhaps a meditative exercise discipline such as yoga or tai chi, are also worth investigating as they can reduce general anxiety. 

Rosie

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1. Try very hard to think about other things, comforting things.

2. Do deep breathing. Really focus on the breathing.

3. I've read that it is bad to try to fight against the panic attacks. Rather than fighting them, accept them and breathe through them. This way, you are more in control and they will pass more quickly.

Having said that, I'm pretty sure some people use anxiety medication during pregnancy. Can you talk about what is safe during pregnancy?
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Yeah... some women do use anxiety medication whilst pregnant. That's because anxiety and stress themselves can affect the baby as well as the meds, so pros and cons have to be weighed carefully on a case by case basis. If the anxiety is mild, you can probably get away without meds. But the risk of postnatal depression is also increased in women who suffer from anxiety during their pregnancies. 

I'm one to read all sorts of stuff online myself, but in this case, I'd ask your doc and trust their clinical judgment... or if not find a new one that has experience with pregnant women. 

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Mind you, I couldn't help but Google... there's some reports that claim Paxil as a drug increases your risk of miscarriage, but also women who've taken it and come out fine and with healthy babies... Could be if you stay off during the first trimester only you can take it during the rest of your pregnancy. Or could be you'd be better off with another anxiety drug, or none at all. Again... talk to your doctor and leave it up to them, of course asking any and all questions you can think of so your fears are allayed. 

By the way what's the last time you weren't taking anxiety meds at all?

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This is a very difficult question.

On the one hand, simply not enough is known about the use of antidepressants during pregnancy to really consider them safe. On the other hand (or several hands, actually), it is known that anxiety in pregnancy increases the risk of postpartum depression AND that suffering from anxiety during pregnancy just really harms your quality of life.

So there has to be a balance between your current and future needs and the potential risks. This is something that can best be evaluated by a psychiatrist who understands your condition in detail.
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I would look for natural anxiety treatments, such as walking in nature, journaling, attending a group session, exercising (swimming would be good during pregnancy), healthy foods, meditation, positive affirmations. There are lots of ways in which you can feel better naturally without medication, especially if your anxiety is fairly mild.

I think it is a great idea to look into a safe way to get off the antidepressants now while you are not pregnant yet so the transition will be easier and you have time to adjust to a new way of being.

Best of luck with everything!
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You have received lots of replies, but the one thing that is missing, I feel, is this: If you have been diagnosed with an anxiety disorder, suffer from panic attacks and are currently in treatment and taking antidepressants, and you are hoping to start trying to conceive soon, what you really need to be doing is asking your psychiatrist about this. He or she is the one with the clinical training, or if your psychiatrist is not too sure about helping pregnant women manage their anxiety disorders, then they will be able to refer you to someone who is.

This is not something you need to figure out on your own. You have help for that. Please use it.
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Paxil belongs to the SSRI class of antidepressants and is one of the safest antidepressants to be taking during pregnancy if you are going to be on an antidepressant at all in pregnancy. Whatever you do though, do not simply stop taking your antidepressant. This can lead to bad withdrawal effects and a relapse in symptoms at the same time. Pure hell. If you are going to wean yourself off Paxil, it needs to be done gradually in a controlled way. Your psychiatrist or prescribing provider will give you tips on how to cope with anxiety during pregnancy at the same time.
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