So a couple months back I decided to wean myself of my meds. Did that and ended up in a bad depression. Finally got back in with pdoc a few weeks ago and she put me on lithium only. Well, a few days later I found out I'm pregnant and stopped taking the lithium because I know it can cause birth defects. I really don't want to take meds while pregnant but I am still in a really bad depression. I have an appointment again with pdoc on Wednesday and would just like to know before I go, what bipolar meds are safe to take during pregnancy? I would just like to do my research in advance so I don't get prescribed something that I'm not comfortable with taking. Thanks in advance for any replies!

[hamster-bamster]

Hi there!

For some reason, this site does not have a sticky on psychiatric medications and pregnancy (or, I am unable to find it), but it does have one on breastfeeding, so that may be a good place to start:

http://forums.psychcentral.com/psych...stfeeding.html

I hope it goes well for you and the baby!

[hamster-bamster]

Whatever you do... start exercising. It really would help with bipolar and it would help with everything else.

My first pregnancy: swimming and yoga and lots of walking throughout the pregnancy. 7+ lb baby born on the due date. I had a compact belly and... ran (sprinted) to catch my bus on campus the NIGHT before I gave birth to him. So I was that agile.

Very quickly postpartum, within a few months, I became skinnier than BEFORE pregnancy. I do believe that being so active while pregnant made that difference.

My last pregnancy with the third child: I was not active at all. I gained too much weight, gave birth to a 9-lb baby solely due to excessive weight gain (she went on to become the shortest kid in her classroom, so it was not in her genes to be so big - I overfed her) and the excessive weight gain really impacted me afterwards. Plus, I had urinary stress incontinence because the extra weight pressed on the bladder (my bladder is not superb to begin with, but that pregnancy made it outright horrible). And, the most horrible thing was getting hemorrhoids which were painful (luckily, they went away soon after the delivery). Hemorrhoids are horrible!! I only had them in that pregnancy - with my first two children, when my belly was super compact, I did not have this problem at all, but with Julia, when I had this enormous belly, I had. I now see that exercise could have prevented them:
HemorrhoidsÂ*|Â*PregnancyÂ*|Â*Your pregnant bodyÂ*|Â*March of Dimes

So exercise is just hugely important for everything. And swimming is the best if you develop varicose veins during the third trimester.

[BlueInanna]

Oh my I have no idea, but congratulations and nice to see you again HP

[hamster-bamster]

Do you already have children, and if you, did you have PPD (post partum depression) with them? I have read that having PPD with prior children increases your chances of having PPD, and a worse PPD, with subsequent children.

[snakeskin07]

HI< I was pregnant and on PSCHE MEDS whatever you do Watch your doctors like a hawk and check every med with a natal specialist. the first trimester is the most dangerous. I was told by a head of neo-natal that going off my meds during the first trimester saved my baby. BE CAREFUL. This was 14 years ago and I was on Paxil it is a class X DRUG it has HORRIFIC birth defects associated with it. Stay away from it. Also watch you don't get pro life doctors when you go to you ob/gyn some of them tend to just say OH TAKE YOUR MEDS without reviewing the side effects that is careless and inconsiderate you want an honest review of each med you have been on and what they will or can do to your child.. USE CAUTION it's a little life and you need to protect it. and GOOD LUCK>. JUST FOR YOUR INFORMATION.. I was on a horror list of meds. MY LITTLE GIRL IS NOW 14.. perfect has a square head on her shoulders is tops of her class and a brilliant young lady you can do this too! good luck again

[Eliza Jane]

Hey,

Glad you posted. I have done fairly extensive research on this topic. I spoke with 3 pdocs and 2 OBs and read a number of journal articles myself. Although we all want to be med free, it is not always possible. I tried, but the situation became dangerous. I ended up on Lamictal (100 mg and then bumped up to 150mg 3rd trimester).

Lamictal is a good choice for pregnancy because it has been around a while and (probably because it is used for seizures too) there is a lot of safety data. They did a 20 yr long pregnancy registry that suggested that the rate of birth defects is no greater than the general population. They actually stopped the pregnancy registry because they had enough information to feel comfortable with the conclusions.

The other med I looked into was Abilify. Abilify is my med of choice and has done wonders for me. The docs would consider Abilify if I had wanted. The issue I had was that there isn't nearly the research out there on it because it is much newer. I didn't feel comfortable with that.

Lamictal has been okay for me. It has helped, but not as much as Abilify. I plan to return to Abilify ASAP (or at least add it to the cocktail). I had previously "failed" on lamictal maybe 5 yrs ago, but I was pleasantly surprised with how I did on it this go around. I will also say that I might have had an easier time on just the lamictal if I hadn't had a horrifically stressful pregnancy.

I wouldn't rely too much on breastfeeding info to make a decision about pregnancy meds. There are differences. For example, the SSRI of choice for pregnancy is Prozac due to a long half life. The SSRI of choice for bf'ing is Zoloft. Paxil is a no no for pregnancy (Category D) but okay for bf'ing.

If you have other questions, feel free to post or pm. It is very hard to find info on this difficult decision!

Best,
EJ

[Eliza Jane]

One more thing! My pdoc also started me on 15 mg Deplin. This is something that is a little newer and people (including pdocs and OB's) often don't think of it. It rx only, but it is actually considered a "medical food" rather than a drug. It is essentially a high dose of a formulation of folate that crosses the blood-brain barrier (unlike most forms). It is used to improve depressed mood. There is some research out there suggesting that many folks with mood disorders do not process folate properly. There are genetic tests for it, but they can be pricey and so my pdoc thought it made sense to just take the extra folate. Of course a huge benefit is that we always hear about how important folic acid/folate is for pregnancy. I think it may have helped my mood some. It is a little hard to tell, but I felt good knowing that I am absolutely getting enough folate for pregnancy.

The downside is that it is rarely covered by insurance (probably because of the "medical food" classification.) My understanding is that it costs $40/month. My pdoc gets a lot of samples and so I actually have not had to purchase it yet.

Worth asking about.

Best,
EJ

[Eliza Jane]

Hey HP,

I was thinking about you and wondering if you saw my posts? Are you okay?

EJ

[Kristiemarie]

My pdoc said lamictal if my ob said it was ok. He didn't but being pregnant helped me a lot. I only started taking it after her birth due to my PPD with my first.

I agree that you have to assess the risks and benefits. An unhealthy mommy is no good for the baby. Take care of yourself and you're taking care of your baby.

Best of luck!