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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Sigolène on July 4, 2001, at 14:37:47
Hi, sorry for my bad english, i speak french.
My depression is resistant to any antidepressant taken alone, so i have to increase AD effect with lithium.
But i plan to be pregnant in the next few weeks, which is not allowed with lithium. If i stop lithium now, i can't work, and it could take mounths before i succeed in being pregnant. And i can be aware of my pregnancy only 2 to 4 weeks after the beginning.
So my question is, is it really too late after 2-4 week after beginning of pregnancy to stop lithium ? Is lithium very risky for the baby ?
And is it risky to stop it abruptly when i know i'm pregnant ?Tanks to any opinion or experience.
Sigolène
Posted by shelliR on July 4, 2001, at 19:36:37
In reply to lithium and pregnancy PLEASE answer, posted by Sigolène on July 4, 2001, at 14:37:47
Sigolene,Your English is perfect. If you do a search on lithium and pregnancy, (try google) you'll find that there is between a .01% and a 1% chance of your baby having a heart defect from your use of lithium. There are some sources that say that when you find you are pregnant you can slowly wean off. Those sources are directed toward bipolar use of lithium, so you can probably decrease faster. My impression from what I have read is that of course it is best to be off before conceiving, but immediately dropping lithium two or three weeks (when you learn you are pregnant) would be almost as good. Some over the counter pregnancy tests can be accurate after one week, so at that point I would assume very low risk.
Shelli
Posted by SalArmy4me on July 4, 2001, at 20:31:27
In reply to lithium and pregnancy PLEASE answer, posted by Sigolène on July 4, 2001, at 14:37:47
Viguera, Adele C.. Nonacs, Ruta. Cohen, Lee S.. Tondo, Leonardo. Murray, Aoife. Baldessarini, Ross J.. Risk of Recurrence of Bipolar Disorder in Pregnant and Nonpregnant Women After Discontinuing Lithium Maintenance. Obstetrical & Gynecological Survey. 55(9):540-541, Sept 2000:
"...Traditional thinking is that pregnancy may protect against recurrent major affective disorder or suicide, but supporting data are very limited. Recent reports suggest that the risk of bipolar illness is not altered. Both mania and bipolar depression are not uncommon in pregnancy, and many pregnant women have safely taken lithium..."
"...Breast-feeding infants whose mothers are taking lithium may have plasma lithium concentrations that are more than 50 percent of those in the mothers. Lithium-induced toxicity was described in an infant who was exposed to the drug in utero and in breast milk. Shortly after the infant's birth, hypothermia (34.9 degreesC rectally), hypotonia, and cyanosis developed; these conditions responded to supportive therapy. On day 5, cyanosis recurred and breast-feeding was discontinued. The infant's plasma lithium concentration was 0.6 mmol per liter, the concentration in breast milk was 0.6 mmol per liter, and the concentration in the mother's plasma was 1.5 mmol per liter. Another infant whose mother took lithium during pregnancy and lactation had no symptoms and had a plasma lithium concentration of 0.03 mmol per liter on day 6 after delivery.
Because of its potentially toxic effects in infants, lithium should be used with caution by breast-feeding women; the American Academy of Pediatrics classifies its use as contraindicated in breast-feeding women. If a woman wishes to try to continue breast-feeding while taking lithium, concentrations of drug in her plasma, in breast milk, and in the infant's plasma should be closely monitored..."
Posted by judy1 on July 5, 2001, at 9:35:14
In reply to lithium and pregnancy PLEASE answer, posted by Sigolène on July 4, 2001, at 14:37:47
Hi,
I couldn't agree more with Shelli's answer. Most studies are done with bipolar disorder when it comes to stopping lithium in pregnancy- therefore the need to taper very slowly in advance of conceiving to prevent possible manic episodes. This would not apply in your case- you could probably stop fairly quickly depending on your dose. The chances as Shelli said of cardiac abnormalities in the fetus are very low if you find you have to continue using lithium while pregnant. One of the great perks of pregnancy however (and I am diagnosed with bipolar and panic disorders) is how great you feel once those hormones kick in. I have found my need for medication greatly reduced during pregnancy and my affective symptoms basically gone. I wish you all the best- judy
Posted by yo-wazzzup on July 6, 2001, at 15:09:43
In reply to lithium and pregnancy PLEASE answer, posted by Sigolène on July 4, 2001, at 14:37:47
>motherisk on-line - Your source for evidence-based information about the safety or risk of drugs, chemicals and disease during pregnancy and lactation. http://www.motherisk.org/ There's a ph.# to contact directly on the site
They will inform you of the most recent studies & data regarding safety of lithium in pregnency. I believe there's a toll free contact number as well... Please, call themHope this helps you.
Hi, sorry for my bad english, i speak french.
>
> My depression is resistant to any antidepressant taken alone, so i have to increase AD effect with lithium.
> But i plan to be pregnant in the next few weeks, which is not allowed with lithium. If i stop lithium now, i can't work, and it could take mounths before i succeed in being pregnant. And i can be aware of my pregnancy only 2 to 4 weeks after the beginning.
> So my question is, is it really too late after 2-4 week after beginning of pregnancy to stop lithium ? Is lithium very risky for the baby ?
> And is it risky to stop it abruptly when i know i'm pregnant ?
>
> Tanks to any opinion or experience.
> Sigolène
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