Pregnant and BP - Meds or Not?

Ask the Expert Patient Health Guide
  • Question

     

    Sassyblonde writes:

     

    I was diagnosed with mania several years ago and went through a trail of medications until the doctors found one that suited me, Symbyax. I recently found out I was pregnant and was told I could not take my medications anymore and the psychiatrist diagnosed with Bipolar disorder at the same time. I am engaged and this whole situation has been very hard on my fiancee'. He doesn't understand my feelings and he is constantly reminding me that I have mood swings and that I am different. I have asked him to please stop telling me and maybe I can forget about this illness at least until I have the baby and can get back on medication. My fiancee' wants another child after this one but I can't do it, I don't know how I am going to make it through the remainder of this pregnancy. My fiancee' tries to be supportive but sometimes I think he is making it harder on me to deal with this illness, especially at this point in my life.

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    Answer

     

    Hi, Sassy. I'm not a medical doctor, but here is what I have reported elsewhere in hearing the leading experts speak at psychiatric conferences:

    1. There is no risk-free decision.
    2. As a general rule, it is wise to stay off meds during the first trimester.
    3. It is advisable to consider getting back on a medication, preferably no more than one, in the second two trimesters.
    4. Depakote and Tegretol should be avoided altogether.
    5. Fish oil, ight therapy, psychotherapy, and ECT may be alternatives to meds.

    The experts all point out solid evidence of very high risk of post-partum depression, psychosis, and mania if a mother is not stabilized on meds before giving birth. A mother who is depressed or otherwise unstable following birth also faces greater challenges in bonding with and nurturing her child.

     

    Again, no decision is without risk. A matter of this vital importance is worth getting a second medical opinion.

Published On: September 20, 2007