Bipolar & Pregnancy?
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Bipolar & Pregnancy?
| Mon, 02-26-2007 - 3:07pm |
What have your experiences been with having bipolar disorder and being pregnant?
I am interested in conceiving during the next year or so, but am nervous about several things. I am nervous that I would plummet after childbirth with post-partum depression. I need to see a doc about my meds (Lamictal, Zoloft, and occasional Seroquel) and how to manage them during pregnancy and how to not take them if that is what is needed. I am nervous about how unstable I might be off meds because I have been taking them very consistently now for at least four years.
Do you all have any advice or suggestions?
Thanks,
Beth
PS As there are other Beths on the board you can call me Beth Anne if it makes it easier.

edited-
amazing, my post was removed because I linked published articles that sites studies done for women who are pregnant, or want to become pregnant, and are bipolar. Well, guess we're not allowed to share valuable information on how to find articles and sited studies. Why? Because according to TOS (apparently, so they say) ivillage has no desire to allow outside referrences to information.
So, feel free to email me if you want the information; otherwise, I suppose search ivillages 'plethora of information' pertaining to bipolar medical journals, articles, and such regarding studies for medications to treat bipolar while pregnant. *rolls eyes*
Edited 2/27/2007 10:15 am ET by xyro
Hi Beth,
I'm pregnant and bipolar. I've posted about this here before so if I'm repeating for you, please forgive me.
When I got pregnant I was on Effexor XR (225mg/day), Topamax (100 mg/day) and new to Seroquel (50 mg/day and stepping up). The pregnancy was a surprise because DH and I had been dealing with infertility for 3 years at that point and I'd given up thinking it was a possibility. My psychiatrist told me to stop everything at once (But! gave me 3 days to wean off the effexor), which threw me into "severe discontinuation syndrome" (can't say withdrawal...that's a bad word with the pharma's) and landed me at the ER where they dx'd me with some sort of inner ear disturbance and sent me home with a script for some anti-vertigo medicine and strict instructions to see my psych about my anxiety (withdrawal tremors are apparently just in your head...they're lucky I didn't start yelling at people. Like that would have helped prove I'm sane.). The non-withdrawal got worse and after a bunch of panicked phone calls to various doctors my PCP agreed to see me. He put me back on all my meds and gave me a reasonable weaning schedule (completely annoying my pdoc). In fact at nearly 6 months pregnant I've only just dropped the last 37.5 mg of Effexor (thanks to being in bed taking sudafed for a week with an upper respirtory infection anyway). Since then I've done a lot of research and had a number of unsatisfactory doctor encounters....Here's some things I've learned.
1. Pdocs in general don't like to treat pregnant women with meds. It seems to scare them and most will want you off everything unless you have some sort of massive crisis.
2. OB's, in general, all seem to think they are treating Andrea Yates instead of the person in front of them. The 3 I've had so far all want me as medicated as possible because they think my psych history is more dangerous than anything an AD will do to the baby. Everything that's gone wrong (severe nausea and vomitting (hyperemesis gravidium), migraine and frequent contractions) gets attributed to anxiety. I actually need my DH present when I see my perinatologist because she won't listen to me at all. She treats me like a crazed child, instead of a highly educated woman who has taken every possible responsible step to manage her pregnancy and psychiatric health.
3. Being completely off meds is hard hard hard. No matter what you are going to hear about how pregnant woman can be immune to depression, that is not my experience. I've dealt with depression this whole pregancy and it's been very difficult for me to bond with the experience in any way. I'm not even sure I fully accept there will be a baby here in a few months. I have no desire to "get ready for the baby". Since I have a 4 year old with some issues of her own I have fake it a lot so she'll be prepared, but I'm not happy and excited like DH. Without heroic efforts I'd probably stay in bed most days.
4. Post partum depression is really bad. I had it with my first child and was told it was "baby blues" and I needed to watch happy things on TV like "Everybody Loves Raymond". A year later, when I still believed serial killers were stalking me and I couldn't leave my ground floor windows unlocked, I was dx'd with ppd and put on prozac for the first time. This time around I have very little hope it won't happen again. In fact I'm already having nightmares about violent death and intruders (this time it's mostly the violent death of the intruders though, so maybe there's progress after all), in addition to recent panic attacks when I'm home alone. For about 5 hours last night I lay awake trying to figure out if anything in my history actually precluded me from owning a gun, because I HAD TO GET ONE TO BE SAFE. Being a non-firearms-friendly type of person it scared me a little this morning. I had always planned on restarting some meds (probably different, more breastfeeding compatible ones) after the birth. Right now it's looking like it might start before the birth though. That's the deal I have with the OB and my tdoc...no meds unless things start to slide downhill from here...and the way is looking more slippery by the day.
So...the basic summary advice I have is that you find out how your pdoc feels about medicine in pregnancy and consider changing if he/she is a no meds person. Then work to find as safe a solution as you can before you ttc. Make sure all of your doctors will be on the same page as far as treatment is concerned and keep your DH in the loop. If I had this to do all over again I would have switched pdocs as soon as I was pregnant and found one that could work with my OB...Oh, and found an OB I didn't hate, and who didn't treat me like I was completely incompetent. 9 months is longer than you think. Dp as much of your own research as possible on medication and pregnancy (there are lots of decent resources in print and on the web) and be ready to put forth your own treatment plan if necessary. It just hasn't been that long since doctors didn't think women with with bipolar should breed at all. There's no consensus on what's best. Be proactive and realistic.
Mary
Hey there!
I'm new to these boards but I saw this and just had to post!
I'm bipolar II and currently trying to conceive again.
The first time I found out I was pregnant, I was on Zoloft, Lithium and Lamictal. As soon as I found out I went to see my Psych. to help with the meds situation while being pregnant. Instead he gave me these two options: 1. Stop taking all drugs right away. or 2. Have an abortion. He actually thought I should follow the abortion option because he did not want me to stop the meds and because I was not legally married yet to my fiance (we did get married a few mos. later) and so I would be an unfit, 'single' mother. He would not refer me to any psychs who work in the area of preg. women and their meds. Needless to say, I never went back to the guy.
Unfortunatley, I had a miscarriage. I've a second one following the first one as well. I did stop taking all the medications at once, which was tough but I made it. I have not started my meds again as I am planning to try to become pregnant again and I have yet to find a psych. who will work with me while I am trying to conceive. It's pretty hard, and like the precious poster said, finding an OB who feels comfortable working with someone on meds is also really hard. I really couldn't find answers anywhere so the only option i felt I had was to stop taking the meds. But I can't believe that there's no help out there and that should be the only option. I think with the right info. and drs and plenty of monitoring everything can turn out okay.
Sorry this is so long! I tried to make it short! But if any one has any more info. on this stuff I'd love to know it!
Thanks for the advice and these boards are really great! I'm glad I found it!
Alexis
I am in the same situation. I TTC last year, and had a miscarriage Feb 2006. We want to TTC again some time soon, but my new Pdoc on my FIRST EVER appointment was trying to push all these medications at me and tried to tell me I wouldn't be a good mother!!!! I do not have rages or anything of the sort. I am an EXCELLENT mother to my stepdaughter who lives with me full time.
I went to my OBGYN and he said to stay on Lexapro only for now, then when we actively TTC to STOP ALL medications for the 1st trimester, then if I HAD to have medication he would put me on Lexapro for the 2nd trimester, but that I would have to go completely off meds for the 3rd trimester.
I wish more studies were done in this area. There has to be a better way. There has to be a safer medication for women who are pregnant/want to get pregnant.
I'd really like to find a doctor that had actually read the research that does exist. So far no luck. The one I currently have actually used the term "date of confinement" instead of "due date" when talking to me about "recent research". I have a big list of new pdocs from my tdoc who said she'd help me out and none of them will return my calls. Seems pdocs are scared of pregnant women.
Mary
Yep--I was told by my OB that it would be really hard to find someone to treat you while pregnant--out of fear of law suits and so on. So there is all this and then I also have been denied long term disability and life insurance because of my bipolar diagnosis, so I cannot even get maternity leave from my job.
Doesn't seem quite fair to me...