I’ve had to navigate the road of finding an appropriate medication to take for my depression while trying to conceive and then determining what I should do when I did get pregnant and later chose to breastfeed. Thankfully, there’s a wealth of information out there and doctors are often well-versed in treating depression during pregnancy. But what if depression is only one side of the spectrum? What if you suffer from bipolar disorder and become pregnant? Here’s what you should know about bipolar medications during pregnancy.
Work with your obstetrician/midwife and your psychiatrist.
Because bipolar disorder (also referred to commonly as manic depression) isn’t as common as depression alone, your obstetrician or midwife may not be as current on the research about your medications and pregnancy. However, the NAMI notes that some bipolar medications, such as the anticonvulsants Tegretol and Depakote, have been shown to cause birth defects. Therefore, work as a team with your OB, midwife, and psychiatrist in order to best determine how to proceed once you decide to become pregnant or realize that you are pregnant. In an ABC News report, Dr. J. Michael Bostwick with the Mayo Clinic points out that if your pregnancy is unexpected, you’ll want to get in touch with each doctor immediately and discuss your options. Likewise, if you are considering becoming pregnant, meet with your doctors to discuss your medications before you start trying in order to minimize any risks to your baby.
Strive for the smallest effective dose of a medication deemed compatible with pregnancy.
According to the National Alliance on Mental Illness, research on bipolar disorder, medications to treat the disorder, and effects on the fetus and newborn is still ongoing. As such, they advise that patients stick to medications that are less likely to have adverse effects, Lithium and first generation anti-psychotics being examples. Since research is continual and each patient and their treatment plan is different, you’ll want to make a specific decision about dosage, switching medications, and monitoring your pregnancy and mood with your healthcare professionals.
Weigh the risks of going off of your medication completely.
For many women that suffer from bipolar disorder, medication is the only answer that works. However, when they become pregnant, they don’t want to take any risks and therefore go off of their medication. A recent piece on CNN discussed the risks of relapse should a woman quit her bipolar medication during pregnancy. In addition, your relapse may be more severe than your initial symptoms when you add in the hormonal changes common during and after pregnancy. Only make the decision to stop medication after meeting with your doctor, and even then, only if you, your healthcare providers, and your spouse are on the lookout for symptoms of relapse.
Resources:
NAMI; Managing Pregnancy and Bipolar Disorder; http://www.nami.org/Template.cfm?Section=bipolar_disorder&template=/ContentManagement/ContentDisplay.cfm&ContentID=84897ABC News; What Special Precautions Should Pregnant Or Breastfeeding Women Keep In Mind While Taking Bipolar Medications?; http://abcnews.go.com/Health/BipolarTreatment/story?id=4359726
CNN; Do pregnancy and bipolar disorder mix?; http://www.cnn.com/2010/HEALTH/06/09/pregnancy.bipolar.disorder/index.html
