Bipolar and Pregnant?
Here is another question & answer session I received in my email.
Q: My daughter is bipolar and has become pregnant — are there any safe drugs for her to take for depression while she’s expecting? (She is 36 and has had one miscarriage.) — V, Alabama
A: That’s a tricky question. Pregnancy can cause major changes in mood and depression, especially for patients who, like your daughter, already have an underlying bipolar condition. Some medications have been tested and are considered safe to continue throughout most of a pregnancy, while others are not. Common antidepressants such as Zoloft and Prozac have been studied extensively and appear to be safe during most of pregnancy, but these medications are more appropriate for depression than bipolar disease. Medications like lithium and Tegretol, often used as mood stabilizers in bipolar patients, have not been studied extensively in pregnancy, so the decision about continuing or stopping them can be a difficult one.
The most important thing for your daughter to do is to consult a high-risk pregnancy expert immediately, as well as a psychiatrist who has experience with medications in pregnancy. Depending on their history, some patients can discontinue medications temporarily, or substitute medications that are safer. Your daughter’s history of miscarriage does not affect the choice of medications for her bipolar disease.
February 1st, 2007 at 1:38 pm
One very very important thing to note for expectant women, as well: women who formula-feed have higher incidences of postpartum depression than women who breastfeed. Also, there are plenty of antidepressants that are safe for women who are nursing, despite what some doctors say.
PPD: http://kellymom.com/ppd/index.html
meds link: http://kellymom.com/health/meds/antidepressant-ref.html
February 28th, 2007 at 10:34 pm
Hi Sarah. Just an FYI that lithium has been studied and contraindicated for pregnant women, particularly in the first trimester. It can cause serious heart problems for the fetus. Depakote is also contraindicated because of the risk of neural tube defects. Since these damages occur before the woman knows she is pregnant it is important for all woman of childbearing age to use adequate birthcontrol and work with doctors to plan pregnancies if taking these meds.
Just catching up,
Just Me