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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 4 to 28 of 28. Go back in thread:
Posted by Lou Pilder on March 10, 2012, at 4:16:20
In reply to Lou's response-kumuntyofdheth » Emily Elizabeth, posted by Lou Pilder on March 10, 2012, at 3:20:24
> > Does anyone have a good understanding of this? I plan to try to get preggo in the near future, so I have been trying to make needed changes to my meds.
> >
> > My pdoc and OB have both said most psych medications are category C. According to wikipedia this means: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
> >
> > However, it seems that within this category there is huge variation. Abilify is category C and pdoc said that under no circumstances would he rx this med during pregnancy (although he said if i wanted to take it, i might be able to find a different pdoc who would.) OB also seemed to think Abilify would be unacceptable. Lexapro is category C and pdoc said he would rx that if it was okay with my OB. OB says any SSRI other than Paxil would be fine during pregnancy, but we'd have to watch the baby for breathing probs upon birth.
> >
> > So, I got off the Abilify and Lexapro (and Welbutrin) but now I am having bad anxiety. (Depression is GONE due to TMS!!!) Pdoc suggested I take Vistaril as needed (also category C). He seemed to imply that was a better option than going back on the Lexapro.
> >
> > Honestly, I wanted to be med-free but I don't know how realistic this is for me. However, if I am taking a risk, I need to be clear on how much of a risk it would be. The FDA seems to imply abilify risk = lexapro risk = vistaril risk. The MD's seem to present it differently though.
> >
> > I'm so confused! Anyone able to shed some light here?
> >
> > Best,
> > EE
>
> EE,
> You wrote,[...anyone able to...].
> I am able to. But there are a lot of prohibitions to me from Mr. Hsiung. These prohibitions could cuase for me to be not able to tell you what I know about taking psychoactive drugs while pregnant.
> I am also under prohibitions from Mr. Hsiung that prohibit me from telling you how you could stop all of the mind-altering drugs that you are taking and get through the potential withdrawal that could arise from discontinuation of these drugs. That would cause for me to mention the foundation of Judaism as revealed to me, which is part of the prohibition to me here.
> So be advised that this community is goverened by Mr. Hsiung and his wishes are carried out by his deputy here in the mind-set that he is doing what he thinks will be good for the community as a whole, and to try and trust him in that.
> Now there is the potential for the death of the unborn child, or the potential for hidious disfigurment if the baby is born alive, when one takes a pcychotropic drug while pregnant. What benefit could outweigh that risk?
> I intend to post here more concerning your request here, unless the rule of three applies.
> LouEE,
Here is a link to an article that I think could have information for you to make a more-informed decision as to take or not psychotropic drugs while pregnant.
Be advised, that I am prohibited here from developing an exposition to show information that IMHO could help people understnd as to if these "new" mind-altering drugs are really new drugs, or new names for knock-offs of old drugs. You could see where I was stopped by Mr. Hsiung in developing that by going to the search box at the end of this page and typing in:[Lou, tramadol]. In that thread, I was intending to develop the aspect of mutations from drugs, before Mr. Hsiung stepped in and reminded me of a prohibition to me. I think that lives could be saved and babies could be born without hideous defects if the prohibitions were not made to me, because more educational material could have been posted by me which could result IMHHHHO for mothers having more information to make a more informed decision as to take these drugs or not while pregnant. You see, there could be a common denominator for classes of psychotropic drugs that goes far back so that the new drug could have the chemical constituants of old drugs modified in some way.
My overiding concern here is to post information here that could save lives which IMO is supportive and educational. You could go to the administative board here and see more of my concerns here that IMO could save your life or prevent a life-ruining condition to you or your child planned.
Here is the link.
Lou
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2767264
Posted by Lou Pilder on March 10, 2012, at 5:13:51
In reply to Lou's response-dhthzpsupoartv, posted by Lou Pilder on March 10, 2012, at 4:16:20
> > > Does anyone have a good understanding of this? I plan to try to get preggo in the near future, so I have been trying to make needed changes to my meds.
> > >
> > > My pdoc and OB have both said most psych medications are category C. According to wikipedia this means: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
> > >
> > > However, it seems that within this category there is huge variation. Abilify is category C and pdoc said that under no circumstances would he rx this med during pregnancy (although he said if i wanted to take it, i might be able to find a different pdoc who would.) OB also seemed to think Abilify would be unacceptable. Lexapro is category C and pdoc said he would rx that if it was okay with my OB. OB says any SSRI other than Paxil would be fine during pregnancy, but we'd have to watch the baby for breathing probs upon birth.
> > >
> > > So, I got off the Abilify and Lexapro (and Welbutrin) but now I am having bad anxiety. (Depression is GONE due to TMS!!!) Pdoc suggested I take Vistaril as needed (also category C). He seemed to imply that was a better option than going back on the Lexapro.
> > >
> > > Honestly, I wanted to be med-free but I don't know how realistic this is for me. However, if I am taking a risk, I need to be clear on how much of a risk it would be. The FDA seems to imply abilify risk = lexapro risk = vistaril risk. The MD's seem to present it differently though.
> > >
> > > I'm so confused! Anyone able to shed some light here?
> > >
> > > Best,
> > > EE
> >
> > EE,
> > You wrote,[...anyone able to...].
> > I am able to. But there are a lot of prohibitions to me from Mr. Hsiung. These prohibitions could cuase for me to be not able to tell you what I know about taking psychoactive drugs while pregnant.
> > I am also under prohibitions from Mr. Hsiung that prohibit me from telling you how you could stop all of the mind-altering drugs that you are taking and get through the potential withdrawal that could arise from discontinuation of these drugs. That would cause for me to mention the foundation of Judaism as revealed to me, which is part of the prohibition to me here.
> > So be advised that this community is goverened by Mr. Hsiung and his wishes are carried out by his deputy here in the mind-set that he is doing what he thinks will be good for the community as a whole, and to try and trust him in that.
> > Now there is the potential for the death of the unborn child, or the potential for hidious disfigurment if the baby is born alive, when one takes a pcychotropic drug while pregnant. What benefit could outweigh that risk?
> > I intend to post here more concerning your request here, unless the rule of three applies.
> > Lou
>
> EE,
> Here is a link to an article that I think could have information for you to make a more-informed decision as to take or not psychotropic drugs while pregnant.
> Be advised, that I am prohibited here from developing an exposition to show information that IMHO could help people understnd as to if these "new" mind-altering drugs are really new drugs, or new names for knock-offs of old drugs. You could see where I was stopped by Mr. Hsiung in developing that by going to the search box at the end of this page and typing in:[Lou, tramadol]. In that thread, I was intending to develop the aspect of mutations from drugs, before Mr. Hsiung stepped in and reminded me of a prohibition to me. I think that lives could be saved and babies could be born without hideous defects if the prohibitions were not made to me, because more educational material could have been posted by me which could result IMHHHHO for mothers having more information to make a more informed decision as to take these drugs or not while pregnant. You see, there could be a common denominator for classes of psychotropic drugs that goes far back so that the new drug could have the chemical constituants of old drugs modified in some way.
> My overiding concern here is to post information here that could save lives which IMO is supportive and educational. You could go to the administative board here and see more of my concerns here that IMO could save your life or prevent a life-ruining condition to you or your child planned.
> Here is the link.
> Lou
> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2767264EE,
Here is a video that I think could give information that could help you make a more informed decision as to take these drugs or not while pregnant.
Lou
To view this video:
A. Pull up Goggle
B. Type in:
[youtube,In Memory of Matthew Schultz]
usually first, posted on May 16, 2009
Posted by Emily Elizabeth on March 10, 2012, at 6:08:25
In reply to Re: Pregnancy Category C » Emily Elizabeth, posted by Phillipa on March 9, 2012, at 23:21:38
Thanks for the reply! It is so scary how thoughts on these things change over the years. When my mom was pregnant with me in 1978, her OB told her she could "have a highball per day". Glad she didn't believe him!
It is also hard because there is such a part of it that is so random. I have known women who have taken such good care of themselves and had terrible problems with their babies. On the other hand, there are crack heads who have babies that are okay-ish. It is so unfair!
But, I do think there is a possibility that I might be able to manage without meds. My wedding is 5 weeks from today(!) and that is certainly ramping up my anxiety! And my depression is gone due to the TMS! Woo-hoo!
I just want all the info.
Best,
EEP.S. My friend just announced that her baby will be named Phillipa!
Posted by Twinleaf on March 10, 2012, at 7:23:06
In reply to Pregnancy Category C, posted by Emily Elizabeth on March 9, 2012, at 22:42:33
First of all, congratulations on all the great things that are happening!
What about having a drug-free period for when you are trying to get pregnant, and also during the first few months of pregnancy? During that time, you could have maintenance TMS if you needed it, and that would probably tend to lower any anxiety you were having. You may well find that the hormone changes of pregnancy give you a sense of well-being.
If you did need medication later in your pregnancy, it would be safer then. The other thing to think of, though, is nursing. That is such a wonderful experience, but I think even the Category C medications are considered contra-indications for it.
Posted by Emily Elizabeth on March 10, 2012, at 9:48:00
In reply to Re: Pregnancy Category C, posted by Twinleaf on March 10, 2012, at 7:23:06
Did you find TMS to help with anxiety? I did 3 weeks of treatment and felt amazing. About a week after I was done I stopped taking my lexapro. And anxiety hasn't been good since. It was been 3 weeks since the last TMS treatment and two weeks off the lexapro.
My search of the web reveals some people saying it helped for anxiety, but as far as I know the FDA only talks about it for depression. I also read somewhere that they have experimented with applying TMS to the other side of your head for anxiety.
So I guess the questions I am left with are: would more TMS help me with anxiety too? Did I not do enough TMS to start with?
I see TMS pdoc in 1.5 weeks for follow up. I'm also seeing a pdoc for a 2nd opinion in 2 weeks and then my own pdoc in 3 weeks! I want to do my homework so I can make informed decisions.
Thanks for the reply!
EE
Posted by Lou Pilder on March 10, 2012, at 9:49:29
In reply to Re: Pregnancy Category C, posted by Twinleaf on March 10, 2012, at 7:23:06
> First of all, congratulations on all the great things that are happening!
>
> What about having a drug-free period for when you are trying to get pregnant, and also during the first few months of pregnancy? During that time, you could have maintenance TMS if you needed it, and that would probably tend to lower any anxiety you were having. You may well find that the hormone changes of pregnancy give you a sense of well-being.
>
> If you did need medication later in your pregnancy, it would be safer then. The other thing to think of, though, is nursing. That is such a wonderful experience, but I think even the Category C medications are considered contra-indications for it.Twinleaf,
You wrote,[...If you did need medication later in your pregnancy, (after the first few months)it would be safer then...].
I am unsure as to what you are wanting to mean. If you could post answers to the following, then I could have the opportunity to respond accordingly.
A. What scientific studies, if any, do you use to make that statement?
B. If a drug is not safe the first few months, why would it be safer after that as you write here?
C. Could it be unbeknownst to you that drugs can cause the death of the developing child or cause brain damage or other life-ruining events or deformaties to the child after the child is born when the mother took drugs after the first few months?
D. If you mean by {safer} that it could be less likely for the developing baby to die or get a life-ruining condition or deormaty from that the mother took drugs after the first few months, how much is less likley and by what authority, if any, do you use to make such a statement here?
E. (redacted by respondent)
Lou
Posted by Emily Elizabeth on March 10, 2012, at 10:09:42
In reply to Lou's request-lezlykleigh » Twinleaf, posted by Lou Pilder on March 10, 2012, at 9:49:29
Lou, you have made your thoughts on this matter known. Respectfully, I ask you to allow others to respond to this thread without attacking them. You do not need to post any more to this thread for me to understand your point of view.
EE
Posted by Twinleaf on March 10, 2012, at 11:32:09
In reply to Re: Lou's request-lezlykleigh » Lou Pilder, posted by Emily Elizabeth on March 10, 2012, at 10:09:42
I had a very strong improvement in depression with the TMS, like you, and also a moderate degree of anxiety reduction. I think it is supposed to damp down the HPA axis, which might account for that. I have also heard of giving it to the right side of the brain, but I think that's pretty experimental and not well- studied.
I hope posters who have gone through pregnancies will see this thread and tell us what they chose to do.
Posted by papillon2 on March 10, 2012, at 17:54:29
In reply to Pregnancy Category C, posted by Emily Elizabeth on March 9, 2012, at 22:42:33
> According to wikipedia this means: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but ****potential benefits may warrant use of the drug in pregnant women despite potential risks.****
You would no doubt be aware of this, but I just wanted to highlight it for other readers. The more I read, the more conscious I am that untreated depression in a mother, particularly during the baby's neonatal and early childhood development, is REALLY BAD.
I used to think it was just a case of a depressed mother not being as able to take proper care of herself. Unfortunately it is a lot more complicated. We're talking about the potential for baby to have serious learning/developmental problems, emotional attachment and feeding issues (again, more important than one would think) and a much higher risk of futre psychiatric illness (of greater severity too).
It's really tricky! I wish Emily all the very best. Perhaps maintenance TMS might be useful?
PS: I think medication from which it is not too difficult to withdrawal might be a key factor. After going through Effexor withdrawal hell, there's no way I'd put a baby through that. Mind you, I'm guessing that if you don't have withdrawal issues from a particular med (which can be problematic for others), baby might not either.
Posted by Phillipa on March 10, 2012, at 18:37:29
In reply to Re: Pregnancy Category C » Phillipa, posted by Emily Elizabeth on March 10, 2012, at 6:08:25
EE first congratulations on your marriage!!!! And double congrats that the Treatment worked for you. Yes times do change. And no not fair about the crack head Moms. I do remember hard times for you in the past. Sounds like you will have no problems without meds. So nice to hear a great success story. Fill me in. Love Phillipa
Posted by Emily Elizabeth on March 11, 2012, at 0:02:18
In reply to Re: Pregnancy Category C, posted by papillon2 on March 10, 2012, at 17:54:29
Thank you for posting this. I think people often get judgmental and assume that the mother is putting her needs above the needs of the child if she seeks medication to treat psychiatric distress during pregnancy. It's not true though. Baby's health and mom's health are intertwined.
I was reading some scary stuff about maternal depression (and anxiety?) during pregnancy leading to low birthweight and delayed development. I think this issue has been inadequately addressed in the medical and popular literature.
Thanks,
EE
Posted by torrid2 on March 11, 2012, at 12:34:26
In reply to Pregnancy Category C, posted by Emily Elizabeth on March 9, 2012, at 22:42:33
They don't study drugs effects on human fetus so all catagory C means is that it is unknow.
I wouldn't take AD's wile exspecting unless your emotional condition became so bad that your emotional state became a greater risk then the drugs.
I'd be less concerned about the use of low dose benzo's then other drug classes. I feel this way because of what we know about children born to addicts and what is unknown about AD's effects on same.
You may find that you will not be needing any meds wile prego, many feel extremely stable wile carring a child.
Getting off drugs now is smart because yhe most damage to the fetus happens in the first part of the first trimester.
My son had a birth defect and I was put on meds in my second trimester due to my emotional condition. I don't know and will never know if the drug was responcible.
Posted by Emily Elizabeth on March 11, 2012, at 13:42:34
In reply to Re: Pregnancy Category C » Emily Elizabeth, posted by torrid2 on March 11, 2012, at 12:34:26
Thank you for your thoughts. It helps to hear from women who have been there.
Best,
EE
Posted by Twinleaf on March 11, 2012, at 15:54:01
In reply to Re: Pregnancy Category C » papillon2, posted by Emily Elizabeth on March 11, 2012, at 0:02:18
I have read the same things. There probably is so much we don't know about psychological states in pregnant mothers, and how they affect unborn babies.
I would be by far more worried about the effect of severe depression, both pre-natally and after birth than I would be about anxiety. There is a lot of research showing how damaging a lack of normal interaction between a mother and baby due to depression can be to the baby's psychological development. But, thankfully, you have found an excellent solution, and there's no reason to think that maintenance TMS
, as needed, won't be just as effective. That,, plus the natural pregnancy hormones, may be all you need to remain well and happy.Even so, I think it is a very good idea to have in mind the least harmful anti-depressant, in case you find that you do need it.
Posted by Phillipa on March 11, 2012, at 18:56:35
In reply to Re: Pregnancy Category C, posted by Twinleaf on March 11, 2012, at 15:54:01
Twinleaf seriously is there one least harmful now? I don't know? Phillipa
Posted by Twinleaf on March 11, 2012, at 19:28:15
In reply to Re: Pregnancy Category C, posted by Twinleaf on March 11, 2012, at 15:54:01
Philippa, that is just what she is trying to find out.
Posted by Phillipa on March 11, 2012, at 20:51:30
In reply to Re: Pregnancy Category C, posted by Twinleaf on March 11, 2012, at 19:28:15
I know but how do we find out as seems most are linked by categories? Phillipa
Posted by B2chica on March 12, 2012, at 8:02:47
In reply to Pregnancy Category C, posted by Emily Elizabeth on March 9, 2012, at 22:42:33
i was told too NO paxil or Depakote.
have you considered an older med?
i nkow sometimes those are better because there's more information on them.i'm on perphenazine now for anxiety but a really low dose.
i will tell you that when i was pregnant with my first i had hyperemesis (constant vomiting) what Finally helped me was the IV solution though they tried zofran over and over it was finally a liquid solution perphenazine that i took! i didnt know it was an ap till now that i'm taking it. So i KNOW that is safe in pregnancy. (of course everyone is different) but ask doc about older course.and btw, my ob said its better to deal with Possible meds and issues than a suicidal mom-to-be.
Best wishes!
b2c.
Posted by Dinah on March 12, 2012, at 9:31:44
In reply to Pregnancy Category C, posted by Emily Elizabeth on March 9, 2012, at 22:42:33
Hi Emily Elizabeth!
I'm so glad the TMS worked. And of course congratulations on the upcoming nuptials. :)
It probably isn't enormously helpful for me to give my experience, since everyone's biology is so different. But FWIW, pregnancy was a pretty good time for me in terms of both depression and anxiety. Especially once the baby started moving. I found I could soothe all my fears by feeling the baby move.
Breastfeeding was another issue entirely. I enjoyed doing it and did it well. I'm glad I had that experience. But I'm not altogether sure the benefits outweighed the disadvantages of a depressed postpartum mom.
I was completely med free during my pregnancy and nursing. My OCD required that.
Posted by B2chica on March 12, 2012, at 11:46:48
In reply to Re: Pregnancy Category C » Emily Elizabeth, posted by Dinah on March 12, 2012, at 9:31:44
same here Dinah. Both preg and nursing was med free for me. but i was actually great during both. it was when i'd stop nursing that Everything came back with a vengence.
Best wishes.
b2c.
Posted by Phillipa on March 12, 2012, at 20:33:24
In reply to Re: Pregnancy Category C » Dinah, posted by B2chica on March 12, 2012, at 11:46:48
Since we last posted about this I have met a lady who doesn't want to stop breast feeding as she has a pituitary microadema that is at the size that if larger means surgery. She feels great while breast feeding. Phillipa
Posted by Emily Elizabeth on March 12, 2012, at 21:24:13
In reply to Re: Pregnancy Category C » B2chica, posted by Phillipa on March 12, 2012, at 20:33:24
Thanks guys for all your thoughts. I will keep you posted!
Best,
EE
Posted by Twinleaf on March 12, 2012, at 22:26:53
In reply to Re: Pregnancy Category C, posted by Emily Elizabeth on March 12, 2012, at 21:24:13
Please do!
Posted by Twinleaf on March 13, 2012, at 16:32:21
In reply to Re: Pregnancy Category C, posted by Twinleaf on March 12, 2012, at 22:26:53
One further thought: because we both have a vigorous anti-depressant response to AAPs and TMS, our brains may also respond to pregnancy in a similiar way. I felt just wonderful - completely free of both depression and anxiety- when I was pregnant and nursing. I think it's very smart to choose a medication in advance, but I'm betting that you won't need it. Several other posters have reported the same extreme well-being.
Posted by Emily Elizabeth on March 13, 2012, at 17:16:39
In reply to Re: Pregnancy Category C, posted by Twinleaf on March 13, 2012, at 16:32:21
I like that positive thought, Twinleaf!! :) Now let's just hope I get pregnant quickly!
Best,
EE
This is the end of the thread.
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