Using Psych Drugs During Pregnancy . . .
* The goal of treatment is to minimize risk of fetal exposure to psychotropic drugs while limiting risks of untreated psychiatric disorder. Ideally the woman should be on the lowest possible doses of medication to treat her symptoms.
* When testing a psychiatric medication's effects on pregnancy, doctors look for three things: the occurrence of birth defects (structural teratogenesis), the occurrence of behavioral problems (behavioral teratogenesis), and the occurrence of unusual symptoms directly after birth (perinatal syndromes).
* If psychiatric meds are prescribed, it is better to use one that has been marketed for 20 years or more.

Lithium -
* is in the FDA pregnancy category D (Positive evidence of human fetal risk exists, but benefits in certain situations (eg, life-threatening situations or diseases for which safer drugs cannot be used or are ineffective) may make use of the drug acceptable despite its risks.)
* Ideally, women should attempt to discontinue lithium prior to pregnancy. If the woman’s symptoms recur she can be restarted on lithium in the second trimester. If she requires lithium maintenance she should be on the lowest possible dose that will stabilize her mood. It is important to remember to reduce the dose of lithium by 50% prior to deliver to avoid toxicity. This is necessary because of changing fluid volumes at the time of delivery.

Seroquel -
* is in the FDA pregnancy category C (Studies have shown the drug to have animal teratogenic or embryocidal effects, but there are no controlled studies in women OR no studies are available in either animals or women)
* There are no adequate and well-controlled studies in pregnant women and Seroquel should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
* A switch to a high-potency antipsychotic (in small doses) is usually recommended, since they are associated with no increased risk to fetus or baby, and is recommended for use during pregnancy in high-risk patients.
* FDA approved in 1996 (under the 20-year criteria)

Effexor -
* is in the FDA pregnancy category C (Studies have shown the drug to have animal teratogenic or embryocidal effects, but there are no controlled studies in women OR no studies are available in either animals or women)
* after delivery, the baby will experience neonatal discontinuation syndrome symptoms (such as irritability, respiratory difficulty and poor feeding). Tapering or discontinuing antidepressants prior to delivery may therefore be beneficial for the newborn, but also introduces the risk of depressive relapse in the mother. Babies born to mothers on antidepressant therapy should be monitored for discontinuation symptoms over the first week of life.

Note: psychiatric meds appear in breastmilk, breastfeeding not recommended while taking these meds

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The ultimate decision rests on you. No one can make you take these drugs while you are pregnant. What level of risk of potential harm to your baby are you willing to accept?

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My advice . . . you've been off psych meds for 14 weeks now. If you can continue to manage your psychiatric symptoms with psychotherapy and support from friends/family, then stay off the meds. Increase your counseling appointments, if possible. Be honest about your symptoms. If you need help, ask for help. Last resort get back on psych meds and cross your fingers your baby is born okay.

(note: I'm not an expert . . . just a concerned pregnant woman)