[Road_to_recovery]

Does anyone have experience with being on meds during pregnancy? I'm off my lithium, lamotrigine, and clonidine. I've been taking my ambien about 1-3x per week still. I am a complete mess. We've talked about latuda but I tried it once before and it seemed to send me into a manic state. Which is strange because it's not supposed to be activating. But I'm so desperate for some kind of relief I'm considering trying it again.

I just want to feel decent enough to take care of my toddler and myself while I'm pregnant. This sleep interruption is making me crazy.

i'm sorry you're suffering so much. are you seeing a therapist? do you have people in your life who can help you out?

[pinkflower17]

That sounds rough. I'm sorry you're struggling so much. Latuda could be something to try at least, given it's safety class. Did you stop all your meds due to your docs request? Or was it your decision? If you decided you can't handle it anymore, there are meds that appear to be pretty safe in pregnancy. Not to step on any toes, but I've see lamictal used a lot during pregnancy without any issues. Not that there aren't risks, but it appears to be pretty safe. And I think you really have to think about risks of meds vs. risks of untreated mental health issues. Maybe something to talk to your psychiatrist with or consider seeing a maternal fetal medicine specialist?

[Road_to_recovery]

I finally got the nerve to call the pregnancy specialist today and they are getting me in in two weeks. Much earlier than I anticipated. So I just have to hold out and cling to what sanity I have for two weeks. But I feel relieved.

Thanks to you both!

[pinkflower17]

Originally Posted by Road_to_recovery

I finally got the nerve to call the pregnancy specialist today and they are getting me in in two weeks. Much earlier than I anticipated. So I just have to hold out and cling to what sanity I have for two weeks. But I feel relieved.

Thanks to you both!

Good! Hang in there these next two weeks

[Rose76]

I've been on lithium, lamotrigine, and clonidine. I didn't find that they did very much for me. Were you really much better when you were taking them? My point is that going off medication may not be such a huge deal, when you consider that medication does not necessarily change all that much for people who are on medication. I sometimes think that a lot of people calm down when they take medication because they think, "Well, I must be calmer now, since I'm taking all this medication." More and more, evidence is coming in that that is precisely true and there is a huge placebo effect with being "on meds."

The not sleeping is a big concern. That's miserable. And that is one thing that meds can really do something about. Of course, the most effective ones are not safe for you right now. I hope you can get some help with the toddler, so that when you really haven't had enough rest, you can get a break to do so.

Consider also that pregnancy hormones can actually be mood lifting. Maybe try and trust nature a little to help you. That may sound like wishful thinking, but it's not totally. You can talk yourself into believing that you are going to be a mess, and you will be. You can tell yourself that, because of a diagnosis you were given, you are doomed to go back and forth between mania and depression. Maybe that isn't so. If you want this second child, try and focus on that. Medication isn't the be all and end all for coping with a mood disorder. People do learn to live successfully with mood disorders, even serious ones . . . and they don't do that totally through medication. This might be a good time to work on those other ways of helping yourself. Even when the pregnancy is over and you are free to take whatever medication you want, you will need those other coping strategies.

Meanwhile, I hope you can get some sleep. That is tough to struggle with.

[pinkflower17]

Originally Posted by Rose76

I've been on lithium, lamotrigine, and clonidine. I didn't find that they did very much for me. Were you really much better when you were taking them? My point is that going off medication may not be such a huge deal, when you consider that medication does not necessarily change all that much for people who are on medication. I sometimes think that a lot of people calm down when they take medication because they think, "Well, I must be calmer now, since I'm taking all this medication." More and more, evidence is coming in that that is precisely true and there is a huge placebo effect with being "on meds."

The not sleeping is a big concern. That's miserable. And that is one thing that meds can really do something about. Of course, the most effective ones are not safe for you right now. I hope you can get some help with the toddler, so that when you really haven't had enough rest, you can get a break to do so.

Consider also that pregnancy hormones can actually be mood lifting. Maybe try and trust nature a little to help you. That may sound like wishful thinking, but it's not totally. You can talk yourself into believing that you are going to be a mess, and you will be. You can tell yourself that, because of a diagnosis you were given, you are doomed to go back and forth between mania and depression. Maybe that isn't so. If you want this second child, try and focus on that. Medication isn't the be all and end all for coping with a mood disorder. People do learn to live successfully with mood disorders, even serious ones . . . and they don't do that totally through medication. This might be a good time to work on those other ways of helping yourself. Even when the pregnancy is over and you are free to take whatever medication you want, you will need those other coping strategies.

Meanwhile, I hope you can get some sleep. That is tough to struggle with.

Granted, everyone responds to different meds differently, but most meds do a lot more than the placebo effect. They can't be approved by the FDA unless they exhibit a benefit greater than placebo. According to the Journal of American Psychiatry, in organic psychiatric diseases (schizophrenia, bipolar, etc), the placebo effect is even lower than in other psychiatric disorders. Depending on the med and the patient, it's usually less than a 20% response. And that response doesn't usually last longer than a couple weeks. Although I also strongly believe people can be med free, there's nothing wrong with meds, and there are some very effective meds that are safe to take during pregnancy.
As we learn more and more about how the brain works, medicating is becoming much more of an effective science. There's actually tests out there now that can detect if you're likely or not to respond to a specific med depending on your genetic profile and the med's mechanism of action.
Again, while I agree going without meds is an option, for a lot of people, it really isn't an option and the health of fetus is absolutely adversely affected by poor mental health in the mother. There's been a ton of studies that show an unstable maternal mental health can convey life long negative consequences. Just as much, if not more so, than some of the current meds.
I just want people to know there are options. A good maternal fetal medicine specialist can help determine the best course of action and when and if meds are safe and what kind.

[Rose76]

Originally Posted by pinkflower17

Although I also strongly believe people can be med free, there's nothing wrong with meds . . . .

Actually, there is.

Best to accept guidance from the doctors who are managing the pregnancy.

PsychCentral has some good info on this topic. For a start, here is a link with an overview: Pregnancy and Psychotropic Medications | Psych Central

[Rose76]

Originally Posted by pinkflower17

There's actually tests out there now that can detect if you're likely or not to respond to a specific med depending on your genetic profile and the med's mechanism of action.

Who's making those tests? I'ld like to buy stock in that company.

Here's a source that suggests that the claims made for these tests are a bit more modest than what you are saying: Genetic Testing Statement | ISPG

An excerpt:

"Some CYP450 enzymes (e.g., CYP2D6, CYP2C19) are highly involved in metabolism of drugs, including antidepressants and antipsychotics. Variation in the genes that encode these enzymes can lead to differences in drug metabolism that can be predicted by genetic markers. Individuals with genetic markers of poor or rapid metabolism may be at higher risk for non-response, adverse events, or drug-drug interactions. . . . . . .

Evidence remains inconclusive as to the possible clinical utility of CYP450 genetic testing in psychiatry, but more research is needed."

Enthusiasm for science is great, but let's not get carried away. Besides, we have learned through many hard lessons over the years that not all that medicine does ends up proving all that scientific. Medicine has a habit of out-pacing the science, with frequent tragic results.

[pinkflower17]

Originally Posted by Rose76

Actually, there is.

Best to accept guidance from the doctors who are managing the pregnancy.

PsychCentral has some good info on this topic. For a start, here is a link with an overview: Pregnancy and Psychotropic Medications | Psych Central

I apologize, I should have phrased that differently. Regardless, there ARE meds that are safe during pregnancy. Latuda for example is a class B. I agree the decision re meds should be left up to the patient and a maternal fetal specialists. But that's what it is, a decision. I work with a couple maternal fetal medicine specialists and they all cautiously use select psych meds in pregnancy. That articles sites old sources. There's newer data and meds out there since 2010, which is the most recent source and I'd be wary trusting a random article by someone who, as far as I can tell is neither a phD or MD. Just my opinion.
All I'm trying to say is I want people to know they have options. It's not a black or white issue.

[Rose76]

Originally Posted by pinkflower17

Regardless, there ARE meds that are safe during pregnancy. Latuda for example is a class B.

There are no medications that are "safe" during pregnancy. Some medications are less risky than others. Doctors will cautiously prescibe a med during pregnancy, despite its risk, if that risk seems to be outweighed by the risk of not medicating the mother.

Here is a good article:
CDC - Medication and Pregnancy

See the article below, also:
Taking Medicine During Pregnancy: Safe and Unsafe Medications

Here is an excerpt:
"*Note: No drug can be considered 100% safe to use during pregnancy." Any pharmacist will confirm that.

[Rose76]

Regarding the drug, Latuda:

"INFANTS EXPOSED IN 3RD TRIMESTER MAY SHOW SIGNS OF EXTRAPYRAMIDAL SYMPTOMS"

Source: What You Should Know About Taking Latuda oral when pregnant, nursing, or administering to children or adults over 60

"Extrapyramidal symptoms (EPS), also known as extrapyramidal side effects (EPSE), are drug induced movement disorders that include acute and tardive symptoms. These symptoms include dystonia (continuous spasms and muscle contractions), akathisia (motor restlessness), parkinsonism (characteristic symptoms such as rigidity, bradykinesia, and tremor), and tardive dyskinesia (irregular, jerky movements). [1] Antipsychotics are often discontinued due to inefficacy or intolerable side effects such as extrapyramidal symptoms. [2]"

Source: Extrapyramidal symptoms - Wikipedia, the free encyclopedia

Category B does not mean "We know it's safe." Here is what it means:

"Category B: Animal studies have not demonstrated fetal risk but there are no adequate studies in pregnant women, or animal studies have shown an adverse effect (other than a decrease in fertility), but adequate studies in pregnant women have not demonstrated a risk to the fetus during the first trimester and there is no evidence of risk in later trimesters)."

Source: Categories of Drugs In Pregnancy | BabyMed

[Road_to_recovery]

I had forgotten that I wrote this. Thanks for the replies and research materials on both sides. I suffered from anxiety and depression with my last pregnancy, although it was mainly at the end. This pregnancy, I'm only 11 weeks in and I've had several panic attacks and anxiety episodes. I cannot live this way. I know that the specialist will help me find something. And I have been trying to do breathing techniques and calming exercise. I'm also seeing a counselor and she pushed me to make the appointment with a specialist.

I can feel myself crossing in to what might be a hypomania. For now I just need to try to sleep and watch my spending. But things will work out one way or another

Thank you

[pinkflower17]

Originally Posted by Road_to_recovery

I had forgotten that I wrote this. Thanks for the replies and research materials on both sides. I suffered from anxiety and depression with my last pregnancy, although it was mainly at the end. This pregnancy, I'm only 11 weeks in and I've had several panic attacks and anxiety episodes. I cannot live this way. I know that the specialist will help me find something. And I have been trying to do breathing techniques and calming exercise. I'm also seeing a counselor and she pushed me to make the appointment with a specialist.

I can feel myself crossing in to what might be a hypomania. For now I just need to try to sleep and watch my spending. But things will work out one way or another

Thank you

Good luck. And good luck with the pregnancy. I hope you find a safe med that works well for you. Take care.