Whether you planned your pregnancy or it was a surprise, there are important issues to consider about your health care during pregnancy. If you have bipolar disorder, then it is important to discuss your treatment options with your health care providers. It is important to stay in close contact with your midwife/OBGYN and your psychiatrist or psychologist because bipolar medications can have an effect on your developing baby, and pregnancy can make your mental illness more pronounced. (1)
Here is an overview of bipolar medications and pregnancy.
One of the most common medications used to treat bipolar patients is lithium. Lithium is often used as a long-term treatment, and can really help to manage the condition. (2) Lithium can increase “the risk of congenital malformations,” and the developing babies are particularly vulnerable to it during the first trimester. It does not, however, increase the risk of miscarriage. (3) There are no known long-term effects on children whose mothers took lithium during pregnancy and/or breastfeeding.
Although there are some risks, and pregnant women taking lithium should be carefully monitored, there are less risks with lithium than many other medications. (1)
Depakote (clinical name divalproex sodium) is used to treat epilepsy and, on occasion, bipolar disorder. Depakote has been proven to be dangerous to the fetus during pregnancy, and so should not be taken during pregnancy unless absolutely necessary. (4) Most women on bipolar medication who are planning a pregnancy will be advised to change to another medication before conception. If you find out that you are pregnant while you are taking Dekapote, contact your health care provider immediately.
Tegretol, or carbamazepine, is considered a Category D medication. (5) This means that it is generally not ideal to take Tegretol during pregnancy, but it may be appropriate in some cases. Tegretol use during pregnancy has been shown to increase certain birth defects, particularly in certain circumstances. (6) Women should generally avoid starting Tegretol use if they are pregnant or planning a pregnancy. If you are already taking Tegretol, speak with your doctor about the best way to continue your treatment. You will probably be advised to take increased amounts of folic acid.
First Generation Antipsychotics
First Generation Antipsychotics include Chlorpromazine, Haloperidol, and Clopixol. (7) Although the decision on whether or not to continue medication during pregnancy is always serious, studies suggest that first generation antipsychotics are generally safe for use during pregnancy when carefully monitored. (8)
Bipolar Medications and Pregnancy
If you are currently taking bipolar medication or think that you may need them, and you are planning a pregnancy or pregnant, you should consult your healthcare team about the best treatment for you. Although there are risks associated with bipolar medication use during pregnancy, there are safe ways to treat bipolar disorder throughout pregnancy with planning and careful management. There are also non-medication treatment methods that may be effective.
For more information about managing bipolar disorder during pregnancy, click here.
(1) “Managing Pregnancy and Bipolar Disorder”,NAMI: National Alliance on Mental Illness
(2) “Medications for Bipolar Disorder”, Psychology Information Online
(3) “Lithium and Pregnancy”, OTIS: Organization of Teratology Information Specialists
(4) “Depakote and Pregnancy”, eMedTV
(5) “Tegretol and Pregnancy”, Wisdom Card, Organized Wisdom
(6) “If a woman takes Tegretol during pregnancy, will it hurt the baby?”,Epilepsy
(7) “First Generation Antipsychotics”, Postnatal Depression & Family, Mothers Matter
(8) “Use and Safety of Antipsychotic Drugs During Pregnancy”, by Einarson, Adrienne RN; Boskavic, Rada MD; Journal of Psychiatric Practice
I am a writer and a mother who is interested in fertility & pregnancy and parenting. I am not a doctor, and you should always discuss any changes in your treatment with your healthcare providers.