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Dr. Bob is Robert Hsiung, MD,
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Posted by phidippus on September 29, 2012, at 14:39:43
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on September 28, 2012, at 20:18:30
There are few, well-controlled studies of venlafaxine in pregnant women. A study released in May 2010 by the Canadian Medical Association Journal suggests use of venlafaxine doubles the risk of miscarriage
Quetiapine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using Seroquel. Taking antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop taking your medicine during pregnancy. If you become pregnant while taking Seroquel, do not stop taking it without your doctor's advice.
Klonopin was given a pregnancy Category D rating due to the problems it caused in animal studies. These studies suggested that Klonopin may increase the risk of various birth defects, including cleft palate and limb defects. However, this is a controversial issue, since some human studies have shown that the risk of birth defects may be very small. Benzodiazepines (such as Klonopin) may also cause other problems, such as withdrawal symptoms after an infant is born.
Recently, the North American AED Pregnancy Registry, located at Massachusetts General Hospital in Boston, Massachusetts, found that infants who are exposed to lamotrigine as monotherapy during pregnancy (lamotrigine was used as the only AED by the mother) have a much higher risk of having an oral cleft problem, than infants born to women in a comparison group and who were not exposed to lamotrigine during pregnancy. Oral cleft problems are birth defects that may involve the lip (cleft lip), the palate (cleft palate), or both. During pregnancy, the normal openings between the upper lip and the nose (seen with cleft lip) or between the roof or back of the mouth and the nose (seen in cleft palate) may not close properly. These problems can often be seen with ultrasound testing and can usually be corrected after birth with surgery.
In this study, of 564 women who received lamotrigine alone, 5 instances of isolated cleft lip or palate (not seen as part of any specific syndrome) were seen in the babies. This data gives a prevalence rate of 8.9 per 1000, which means that oral cleft problems may occur in 8.9 of 1000 women treated with lamotrigine monotherapy. This number is 24 times higher than the risk of oral cleft problems seen in babies from the comparison group used in the study.
Posted by sleepygirl2 on September 29, 2012, at 18:28:31
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by phidippus on September 29, 2012, at 14:39:43
Thanks for the info.
I must admit, this will be a challenge.
Posted by phidippus on September 29, 2012, at 19:16:16
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on September 29, 2012, at 18:28:31
Most women go off their meds when they become pregnant. Are you bipolar?
Eric
Posted by sleepygirl2 on September 29, 2012, at 20:27:24
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by phidippus on September 29, 2012, at 19:16:16
No, just anxious, mostly.
Posted by phidippus on September 29, 2012, at 21:09:34
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on September 29, 2012, at 20:27:24
Then you probably don't need the Lamictal. What other meds are you on?
Eric
Posted by phillipa on September 29, 2012, at 21:18:36
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by phidippus on September 29, 2012, at 21:09:34
My third was born before they worried or knew there could be problems with meds and newborns. When pregnant was taking valium, was prescribed placydil 2 pills at bedtime, or and 2 glasses of a very strong red wine. I guess this explains why for l8 months after birth the daughter didn't sleep at all, couldn't even tolerate breast milk. Used to projectile vomit each feeding and have to be refed. The best part is went into false labor was in hospital for night and the obgyn gave me two sequenols for sleep. She's fine today. Cried 24 hours a day for months and ended up in ICU nursery about every 2 weeks where they drugged her. Was not a fun time at all. Phillipa
Posted by sleepygirl2 on September 29, 2012, at 21:31:49
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by phidippus on September 29, 2012, at 21:09:34
Effexor 150, klonopin .5, seroquel 50
Posted by sleepygirl2 on September 29, 2012, at 21:33:28
In reply to Re: Lamictal withdrawal??, posted by phillipa on September 29, 2012, at 21:18:36
That sounds awful :-(
Posted by phidippus on September 30, 2012, at 15:19:23
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on September 29, 2012, at 21:31:49
You're on relatively low doses of your medications. Do you think you could do without them for 8-9 months?
Eric
Posted by phillipa on September 30, 2012, at 18:55:33
In reply to Re: Lamictal withdrawal?? » phillipa, posted by sleepygirl2 on September 29, 2012, at 21:33:28
It was horrible. B2Chica did well without meds with pregnancy. Maybe you can write her and talk with her? Phillipa
Posted by sleepygirl2 on September 30, 2012, at 20:33:09
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by phidippus on September 30, 2012, at 15:19:23
Probably, but I'd like something there for anxiety, if only prn.
I'm glad I'm only on .5 of klonopin. Less medication to withdraw from. It used to be 1.5.
The Effexor used to be higher too, went down after lamictal was added.
I suppose I'll only find out through the process. Effexor can be rough to get off Of, but I've dropped Effexor before, 300 to 225, and 225 to 150. I recall feeling depressed while trying to go lower than 150, so I stayed on it.
I knew someone who stayed on Prozac through her pregnancy. I wonder about Prozac. Maybe the least difficult to withdraw from?
Seroquel, again, thankfully low dose. Insomnia, agitation and the itchies when going down in that, but still not impossible.It's going to be rough. I'm anxious right now. Do I know why? No. I feel buzzy.
Posted by phidippus on October 1, 2012, at 13:03:51
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on September 30, 2012, at 20:33:09
I'm sure you can remain on the Effexor as it is the medication least likely to cause a problem with any pregnancy.
I'm anxious right now. Do I know why? No. I feel buzzy
Go for a walk :)
Eric
Posted by sleepygirl2 on October 1, 2012, at 15:31:28
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by phidippus on October 1, 2012, at 13:03:51
I ended up sorting laundry, and tidying.
I did 4 hours of yard work today, maybe a walk later.:-)
Posted by phidippus on October 1, 2012, at 16:40:44
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on October 1, 2012, at 15:31:28
Good Job.
so, are you going to go off the Lamictal?
Eric
Posted by sleepygirl2 on October 1, 2012, at 17:59:45
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by phidippus on October 1, 2012, at 16:40:44
Thanks :-)
Yup, 150 and holding. Next appointment Thursday, might drop the dose again.
Posted by phidippus on October 1, 2012, at 22:56:52
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on October 1, 2012, at 17:59:45
Is Lamictal prescribed to treat the anxiety?
Eric
Posted by sleepygirl2 on October 2, 2012, at 4:34:50
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by phidippus on October 1, 2012, at 22:56:52
No, depression and mood lability.
Posted by jane d on October 2, 2012, at 4:52:48
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on October 2, 2012, at 4:34:50
> No, depression and mood lability.
>Insomnia? Or just practicing for parenthood?
:)Hang in there. I. had no withdrawal problems. But I think you're doing the right thing taking it slowly
Posted by sleepygirl2 on October 2, 2012, at 8:35:11
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by jane d on October 2, 2012, at 4:52:48
I woke up a couple of hours too early today.
Tired.... :-(
Posted by phidippus on October 2, 2012, at 18:23:15
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on October 2, 2012, at 4:34:50
Do you think its been helping?
Eric
Posted by sleepygirl2 on October 3, 2012, at 8:10:45
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by phidippus on October 2, 2012, at 18:23:15
To some degree... But maybe not enough to be worth it
Posted by phidippus on October 3, 2012, at 10:04:10
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on October 3, 2012, at 8:10:45
Lamictal is for bipolar people and those with epilepsy. Sometimes its used off-label to treat depression. I don't like the drug much.
Eric
Posted by SLS on October 5, 2012, at 8:57:52
In reply to Lamictal withdrawal??, posted by sleepygirl2 on September 25, 2012, at 7:32:38
> I dropped from 200mgs to 150mgs 6 days ago.
> Well, my anxiety has been a bit intense. My thoughts are annoying, too many of them, one leads to another, which leads to another, etc. I'm feeling dizzy too, didn't sleep well, my head hurts... feel like maybe I'm getting some type of cold/flu, but I don't have significant congestion.
>
> This sucks! I don't know if this is some withdrawal effect, or just me. It's just a 50mg drop. I took 200mgs last night just in case that's what this is.
>
> Anyone notice any lamictal withdrawal effects when tapering down?
Yes. I experienced severe depression when I reduced my dosage from 300 mg/day to 200 mg/day. However, after a few days, I recovered and recaptured the antidepressant effect. This is indicative of a temporary withdrawal rebound depression.Your situation is different in that you have not recovered after a week or so. I have only read your first post, so I am unaware of any information you have added to this one. As you describe it here, it is more likely that you have relapsed at 150 mg/day and that you need to take 200 mg/day to recapture and maintain a therapeutic effect.
Now, if anxiety was never a component of your illness, I would consider your experience more of a withdrawal reaction, especially in light of the dizziness and other things you described. I will try to read the rest of the thread to see how things have resolved.
I have also had "partial" relapses while being treated with a dosage of a drug that is not quite high enough to reach a full response. I experience a dysautonomia that includes anxiety, dry mouth, heart palpitations, dizziness, blurred vision, mydriasis (eye pupil dilation), and a few other things. This might be what is happening to you if 150 mg/day is close, but not quite enough to produce a stable improvement.
- Scott
Posted by SLS on October 5, 2012, at 10:20:28
In reply to Re: Lamictal withdrawal?? » phidippus, posted by sleepygirl2 on October 3, 2012, at 8:10:45
Hi.
I wish you luck in your decision making process regarding drug treatment and pregnancy.
Paxil is definitely harmful to the development of the fetal heart. It causes deformities in the structure of the atrium septum (interior heart wall). The first trimester is critical. Pulmonary hypertension is also a problem. With any SRI, the infant is going to experience withdrawal immediately after birth. It was at one time misinterpreted as being colic, as the infant displayed distress. Premature births have been associated with SSRIs for over a decade.
You probably know all of this.
Some argue that to allow a woman to suffer depression during pregnancy might prevent her from caring for herself properly and ultimately affecting the health of the fetus. The effects of increased cortisol production during chronic depression and anxiety is also a consideration. I'm pretty sure that it affects the placenta.
Maybe you'll get lucky. Some woman actually experience an improvement in depression during pregnancy in the absence of psychotropics.
I'm glad that Phiddipus provided all that valuable information. As severe as my untreated depression is, I would have a difficult time deciding what to do were I confronted with your dilemma.
Good luck.
- Scott
Posted by sleepygirl2 on October 5, 2012, at 16:26:53
In reply to Re: Lamictal withdrawal?? » sleepygirl2, posted by SLS on October 5, 2012, at 8:57:52
I seem to be doing ok now, but the dose remains at 150.
My Pdoc is cautious. It seems overwhelming at this point to think about getting off this, and the 3 other meds. I'm just glad they're not at high doses.
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