Posted by Angielala on February 11, 2005, at 21:25:35
Hey all... I just want to update anyone with the information I recieved from the pdoc specialist i saw on Wed in Boston.
I take Lamictal, just came off of Paxil. I am 6 weeks pregnant now. My visit was to go over my history of bipolar and medication I have taken and take now.
In my particular situation, staying on Lamictal during the pregnancy is what the specialist has recommended. I was so relieved to learn that there have been *NO* cases of unhealthy babies born to women who took Lamictal through out the pregnancy.
Lamictal is still new, but this specialists' group works with the Lamictal registry to keep tabs on such things. She explained that the risk would be by going off of the medication during the pregnancy.
In my case, a bad depression (which I am prone to) could cause an early labor, miscarriage, etc. Bad manias can also cause big problems through out a pregnanct.
So I am staying on my meds, and she will be monitoring my depression and anxiety through out the pregnancy. She let me know that going on Klonapin (sp?) and/or an SSRI may be useful after the 1st trimester is complete. We'll see.
I asked about breastfeeding. I thought that breastfeeding was out of the question because of the medications. She explained that, in my case (I want everyone to know that this is all according to my history), getting up every 2-3 hours at night after the birth will cause me to be unbalanced. She recommended that formula be used so that I can get a few more hours of sleep and my husband can do one of the nightly feedings. This is all because of the wicked Post-Pardum Depressions that many can get, and Bipolar women almost always swing into. The more sleep I can get, the less wicked it will be.
Also- the post padrum depression may cause a post pardum psychosis, so she will monitor me for it. If need be, I may need to go on Zyprexa (sp??) for 2-3 weeks afterwards to ward that risk off. It depends on how I do. I have had minor psychosis in the past, and this is why it's something she's going to watch.
I was surprised that I'm not so limited... it's good to know that if things do get bad, an SSRI can be given to me, and that Klonipin (sp?) maybe more useful than Xanax to help calm me.
Oh- one other thing that I found out from her- there is no toxicity from taking too much Folate (Folic Acid). During your 1st trimester, if you are on medication for mental health, take extra folic acid. Prenatal vitamins have between 400-500mcgs. An extra 800mcg of Folic Acid will help the neural tube develope during that first trimester. The medications taken for mental health are more likely to effect the neural tube during the 1st trimster- so the Folic Acid helps defend that. It's piece of mind that I would like to give someone if they haven't found a doc yet and are in the early early stages of pregnancy.
Like I said- this is all based on my history of Bipolar and my history of medications, so it's not the same for everyone. I just want to give some idea of what options there are out there.
This is where I went: http://www.womensmentalhealth.org/
It's in Boston, Massachusetts. If you are not in the area- it's worth the visit to the website. Also- everyone gets a free first consultation, so if you are within driving distance and you really want piece of mind, I can tell you this group is worth it.Some other things I learned...
Because we end up having to do a lot of our own research via the web and reading, becareful. For example, there is a lot of current research happening with Paxil and pregnancy. Studies came out last week in the NYT saying that it's not good to use during pregnancy because of defects found. Because we do a lot of our own research, many women will go off Paxil without cinsulting a doctor, or a primary care doc will say "Hey, it was in the NYT, must be true" HOWEVER, the research being done doesn't let on as to what the control group as been. Meaning they might say 50 women had problems on it, but it won't say if these women were on other drugs at the time, or had issues like alcohol or genetic issues. Now there are women who would be a lot better off being on Paxil off of it because of this jaded research. Seek more info, ask more than one doctor. Make calls to places like the place I linked above, ask questions. Another example is ADitvan/Xanax during pregnancy. There is a study that claims that these drugs cause neural tube defects. At the surface, it seems to be confident reserarch. Looking deeper- one finds that this only occurs in women who took 4-5mgs of Xanax a day. That is a high dose of Xanax. There are many women who only take Xanax as needed, or take 1mg a day- .5 in the morn, .5 at night... or some even take only .25 as needed. These women do not have a risk of tube damage as the former women do.I want to make sure women do their own research and then verify it among different groups of people and doctors- it's important for their own piece of mind. Don't let one resource be your only resource- don't let this post be what makes or breaks you- don't let one person who knows someone who knows someone be where you get you only advice. Search around, ask questions, don't give up. You will feel a lot better once you reach a decision with a plethora of information.
I hope this helps someone out there, I know I was very lost with all of this only 3 weeks ago. Don't feel alone, there are people and places that specialize in this, there are doctors that know. Fidn them.
Ok, that's my bit.
~Angielala
poster:Angielala
thread:456550
URL: http://www.dr-bob.org/babble/social/20050205/msgs/456550.html