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what are the risks of continuing bipolar medications while pregnant?

arangel71113
05/24/09

I am bipolar. Planning to start trying to have a baby in the near future. I have read many mixed opinions and i would like to know from a doctor or a mother who has been through this, is it safe to continue medication therapy while pregnant. My Psych wants me to stay on abilify, remeron , provigil, and neurontin. Please help I need it. By the way I am not nor have I ever been suicidal/homicidal so going off the meds seemed more okay to me, but not to my psych.

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Answers (4)
Virginia W.
Virginia W.
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poet published in The Paris Review; M.A. in English from UT

I am a published poet (and editor). Although recently diagnosed, I...

Monday, May 25, 2009

  I would get a second opinion from another doctor, preferably a doctor at a medical school.  If your doctor objects to this, then he is a bad doctor.  I have heard it is very bad to stay on meds while pregnant or breastfeeding, but I don't know about these exact drugs.  Ask your pharmacist, too; sometimes they are more helpful than doctors and just as knowledgable. Another important thing to remember is to tail off slowly.  I recently had to quit my meds all of a sudden on dr's orders, and it has been rough.  You have to plan getting off the drugs as well as the pregnancy.

 

But, above all, you do not want to mess with your baby's brain!

John McManamy
John McManamy
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Author and Advocate

John McManamy is an award-winning mental health journalist and...

Friday, May 29, 2009

Hi, Arnagel. No decision is risk-free, but here are things to consider: On no meds your risk of a postpartum episode, including depression, mania, or psychosis goes way way up.

 

The knowledge that you are pregnant means that you have already passed the period of highest risk to the fetus.

 

You might want to ask your doc if he/she can take you off some of your meds - say keep you on just one - but that is a decision between you and your doc.

 

There is general expert agreement that you need to be stable in your last trimester. Your hormones are going to play hell with you during delivery and the risk of post-partum destabilization is very very high for bipolar moms. This destabilization affects your baby's health, too - if you're not stable there will be major issues bonding with your baby, with potential major long term effects.

 

Your concern is very valid. But don't feel you have to be a hero. Have a good long discussion with both your pdoc and family doc, get second and third opinions if you feel the need, and remember - there are no right or wrong decisions, just informed and uninformed ones.

 

 

John McManamy
John McManamy
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Author and Advocate

John McManamy is an award-winning mental health journalist and...

Friday, May 29, 2009

Hi, arangel. Just reread your question and noticed you said "planning to start trying." I based my response a minute or two ago on the mistaken assumption you were already pregnant. Oops, sorry. A new consideration:

 

The greatest risk to the fetus occurs during the first trimester, so not being on meds when trying to conceive is a good option, one that is endorsed by Zachary Stowe of Emory University (see article). But of course going off meds involves risks to your mental health. The crucial thing is you need to be stable in the third trimester for reasons I list in my previous answer.

John McManamy
John McManamy
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Author and Advocate

John McManamy is an award-winning mental health journalist and...

Friday, May 29, 2009

Hi, arangel. Just reread your question and noticed you said "planning to start trying." I based my response a minute or two ago on the mistaken assumption you were already pregnant. Oops, sorry. A new consideration:

 

The greatest risk to the fetus occurs during the first trimester, so not being on meds when trying to conceive is a good option, one that is endorsed by Zachary Stowe of Emory University (see article). But of course going off meds involves risks to your mental health. The crucial thing is you need to be stable in the third trimester for reasons I list in my previous answer.

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