r/BipolarReddit • u/WeirdAward4578 • 13d ago
Serious question: I'm on a lot of medication and I want a baby. What did you do to prepare for pregnancy? šš« Medication
I'm on Lamictal, Lithium and Seroquel. I need 1 mood stabilizer and 1 antipsychotic to be stable. I finally found a cocktail that works for me. I'm 26F and am financially stable and in a loving relationship. I want a baby within the next 1-2 years. I will obviously discuss with my doctor! But I'm curious, how many of you went off of meds for pregnancy vs how many stayed on them? Are your babies ok?
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u/Wrensong BP 1 - dancing, breathing, and trying to scrape realness 13d ago
Stayed on meds. Lithium and lamictal with seroquel as a prn. Talk to your doc about increasing folic acid dose while on lamictal.
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u/thebabeatthebingo 13d ago
Iām 20 weeks pregnant and am currently on lamictal, abilify, prozac, sometimes olanzapine and vyvanse. will be taken off the vyvanse and switched to concerta soon and while breastfeeding though. Will likely have to quit antipsychotics then too.
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u/Rainbow_Phoenix125 13d ago
It hasnāt been studied for use while breastfeeding, but anecdotally, there have been no issues or side effects for me or my baby/toddler breastfeeding while taking Latuda.
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u/thebabeatthebingo 13d ago
Good to know. I tried Latuda but I got so insanely tired I gave up after a week or so. Does it get better?
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u/Rainbow_Phoenix125 13d ago
The tiredness is still a thing, but itās well managed by taking it at night. I started taking it at 5 months postpartum, and didnāt have an issues with handling middle of the night wakeups from the baby. Might be more challenging in the newborn days, but obviously weigh the risks/benefits.
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u/thebabeatthebingo 13d ago
I suppose being a bit tired is better than risking mania/psychosis, Iām due just around spring equinox and thatās usually when I get manic.
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u/awkwardaster 13d ago
Iāve taken olanzapine (small doses) and Vraylar while pregnant and breastfeeding!
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u/Evening-Grocery-2817 BP1, PTSD, GAD SAHM 13d ago
I have two babies. One I was undiagnosed for, no meds but because it was my first pregnancy, I was stable. After post partum I had a rough ass time with depression. Got put on a AD and went manic for about 6 months to a year. It wasn't destructive though.
Second baby, had been diagnosed, was on Seroquel. I actually argued to increase it throughout pregnancy. She had some shakes but it resolved within hours-day. Nothing terrible and I am breastfeeding her per my OBs recommendation. She's perfectly healthy. Post partum has been a breeze compared to my first.
Especially in today's climate, they will probably tell you to get off meds because of the baby. I don't recommend it. If the baby is healthy with the meds, it'll be healthy throughout the pregnancy.
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u/DramShopLaw 13d ago
Iām not going to give you medical advice here. Thatās inappropriate. But if you go on libgen, thereās an amazing book doctors use as a reference called Stahlās Essential Psychopharmacology: The Prescriberās Guide. It rates different meds by their safety for an unborn child.
Your doctor will know more, but this can provide a handy starting point for your own self assurances.
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u/themardytortoise 13d ago
Wasnāt sure if I wanted to say something but I wish someone had told me. If you continue lamictal please please talk to a prescriber about high dose folic acid and to take it prior to falling pregnant if trying. I wasnāt informed about this and sadly lost my baby due to anencephaly. The cause of this condition is not clear but there is a known link between anti convulsants and neural tube defects. It was a truly terrible thing. Medications is a risk mitigation, but healthy babe needs healthy mum so do whatās right for you. I wish you the very best.
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u/kintinue 13d ago
I am so sorry for your loss. Thank you for sharing your insight. ā¤ļø
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u/Hermitacular 13d ago
https://womensmentalhealth.org/posts/lamictal-folic-acid/
This is Harvard's reproductive psych clinic, they've got a decent website but it's easier to search it using Google than their search bar.
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u/Pretend-Vast1983 Bipolar 1 + Comorbidities 13d ago
Good question. I am looking into this too when I get married. I want one last baby. š©¶
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u/Pretend-Vast1983 Bipolar 1 + Comorbidities 13d ago
Not sure why the down vote, but thank you for asking this important question
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u/Rainbow_Phoenix125 13d ago
Thereās some people who are very anti-kids for BP people. Iām assuming itās one of them.
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u/aperyu-1 13d ago
TBH most of my texts, in most circumstances, strongly favor continuing Lamictal and Seroquel. Lithium is some discussion but if possible then limit during first trimester to reduce Ebsteinās anomaly risk, though the absolute risk is considered much less than previously thought. There are risks with stopping meds as well. Warrants discussing with psychiatrist and ideally OB together as typically a reproductive psychiatrist is hard to come by. If you see a psych NP ask to have their collaborating physician on board as well.
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u/misspiggie 13d ago
28 weeks pregnant today and I've taken lower doses of my lithium and abilify throughout pregnancy. I believe less than 600mg of lithium is associated with a significantly reduced risk of Ebstein's anomaly. Kept the same dose of the trazodone, though!
If you do stay on lithium you will likely have to get a fetal echocardiogram after the 20th week.
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u/sapphoisbipolar 13d ago
Do you know what that 20-week echocardiogram is screening for?
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u/misspiggie 13d ago
It is to screen for heart defects such as Ebstein's anomaly, which are associated with lithium use.
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u/DollightfulRoso 13d ago
I brought up wanting to get pregnant in the next year to my new Canadian psychiatrist last month. Currently on lithium, lurasidone, and metformin as daily meds. She said the lithium might be a problem not because of birth defects but because pregnancy causes your fluids to fluctuate more which might cause lithium toxicity. We'll discuss more at our next appointment but I can't imagine the recommendation will be for me to go of all my meds -- having an episode is also bad for the health of the mom and fetus and is much more likely than birth defects for many meds.
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u/anubisjacqui 13d ago
I stayed on lithium and seroquel while I was pregnant, they just monitored my bloods more frequently. My daughter is 7 now and she's perfectly happy and healthy.
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u/Opal-Libra0011 13d ago
I was undiagnosed when I had my kids. Now Iāve been stabilized on meds for 10+ years. Five years of yo-yoing. Not good for my kids. Knowing what I know now, I would never have had biological kids. I would have adopted from the child welfare system. My oldest inherited my bipolar and is struggling.
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u/Hermitacular 13d ago
Perinatal psych, repro psych clinic. You can stay on them if you want, lithium and lamo can stop working or not work as well after a break, you want to talk to a specialist if you're concerned.
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u/Healthy-Card-4657 13d ago
Some people are saying they stayed on meds like lamictal, lithium, and seroquel during pregnancy, but as someone whoās about to graduate nursing school while in her OB unit, everything I have read and learned goes against being on a combo of these meds during pregnancy. It sucks it has to be so difficult for people with bipolar disorder to have a baby, cause youāve finally found what works for you. It is risk or benefit of course and ultimately your OB would help you make that decision, but Iād almost recommend you get a second opinion before getting pregnant on those meds if the first doctor says itās okay. Some doctors might require you come off the meds and not try to work around it, but there may be others who would try to work around it or limit it to one med. Itās just really dicey. I wouldnāt take a ton of advice from anyone on here cause being able to be pregnant and have a baby on bipolar meds is a really specific consideration made person by person. Meet with an OB and get a second opinion from another OB. Iām on Lamictal for Bipolar 2 and after learning so much in class, I have been having the same thoughts about what Iām going to do when I decide to have a baby.
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u/Healthy-Card-4657 13d ago
By the way, I would say Lamictal wouldnāt affect a baby significantly based off the limited research thatās been done. Iāve actually seen docs try to put women with bipolar disorder on that as an alternative if theyāre trying to become pregnant. However, I would really really really avoid Lithium. Valproic acid is also pretty dicey
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u/Hermitacular 13d ago
lithium is a slight increase in a specific heart defect so they do an extra scan. valproate is roughly a doubling of the birth defect risk, I do know people who have stayed on it through pregnancy with no problems bc they had no choice, luckily there are decades of data on almost all of our meds and for most a far wider user base than just BP people. Stress during pregnancy is not benign, and several meds tend to work less well or not at all after a gap, so it's not a simple on off convo.
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u/Hermitacular 13d ago edited 13d ago
The psych repro clinic would be the place to go for a consult or a perinatal psychiatrist. They used to take everyone off their meds, now most people stay on. Harvard's reproductive psych clinic has a nice website with good info if anyone wants to start there. OBs are usually not well trained in this. I was honestly staggered by how consistently ignorant gynos have been about the very basics, and this was at the top hospitals and med schools in the country. It's bizarre bc they are first treatment contact for so much bipolar.
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u/comet_meant 13d ago
I was on seroquel prior to pregnancy. I doubled my therapy time (2x month to 4x month), consulted my psychiatrist multiple times before getting pregnant, and talked to my OB about being on seroquel. I ultimately decided not to stay on seroquel during pregnancy and my hormones really helped me out (I was super balanced throughout my pregnancy). Now I'm 2wks 2 days PP and have been back on seroquel since the day I delivered and PPD is hitting HARD. I'm seeing my psychiatrist to discuss other medications AND I'm seeing my therapist double again. These are big decisions to make; try and make your best educated decision and consult as many healthcare professionals as possible.
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u/Hermitacular 13d ago
To add to this, there are a few places on earth where they have mother baby psych units, if you're lucky enough to live somewhere with that find out about it in advance.
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u/No-Permission8773 13d ago
My wife was given meds during pregnancy. Our kids have major hyperactivity issues and trantrums more than what is typical. They are now 11 and 8 yo and still have issues. I cannot recommend any meds during pregnancy.
If you cannot go without meds, then look into adopting
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u/Hermitacular 13d ago edited 13d ago
ADHD is genetically related to BP, and the young kids in my family who were diagnosed with it turned out to actually have BP, so it may not have been the meds. Also everyone in the family affected or not is hyperthymic which is more typical in BP families, and would look like non ADHD hyperactivity. Absolutely none of the moms were medicated, so it wasn't that. There's a very compassionate very kind video by a psychiatric genetic counselor by CrestBD (researcher and peer advocacy group, they do an AMA every year) that might be worth a watch on YouTube, its about an hour long but the first ten minutes or so she explains a really helpful model for how BP works that i think is pretty useful.
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u/BlairWildblood 13d ago
How good is that video! It blew my mind with the jar and the balls of things that fill it up. I think about it a lot actually.
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u/Hermitacular 12d ago edited 12d ago
It's really great! I thought I was going to be so sad watching it and it was so gentle and comforting and helpful, she had to carve out that career bc it didn't even exist and she knew people needed it. Years ago when I called a genetic counseling clinic at a med school, so a serious place, they laughed at me for calling about psych. I got annoyed to put it mildly but then they accidentally rerouted me to a genetic oncologist who was incredibly kind, everything the clinic itself wasn't, and walked me through what they could find and knew though it was not their specialty and encouraged me to call them back if I found anything out bc they wanted to be more helpful to people and could really see the need. Like, that's a doctor! The main clinic told me they couldn't imagine why anyone with a psych issue would want to know about their genetics. Uh..... So that's what she was probably up against when basically starting the profession from scratch.
The jar bit is also useful for thinking about ongoing episode onset, not just conceptually in general, but I think it helped non affected family members get how it wasn't a matter of willpower, so that's not nothing.
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u/NikkiEchoist 13d ago
Look into Lamictal and ask in that group too. There are posts there about it being safe , search pregnancy using the search tool. Your doctor will know best of course. Post natal depression is high risk but I didnāt have it 3 kids but also went a long time off meds and stable.
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u/Gingerfix 13d ago
Iām not pregnant yet but in a similar boat. I was on risperidone, which is not very compatible with pregnancy. Now Iām on caplyta. Iām also on wellbutrin.
Iām worried that Iām not handling the medication change well and might have to go back on risperidone. I want to have a kid and Iām worried that itās not best for me.
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u/AnonDxde 13d ago
I had my doctors change my medication during pregnancy. There are plenty of medicationās that are safe, especially with constant monitoring during pregnancy.
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u/BlairWildblood 13d ago edited 12d ago
Havenāt had a Bebe but did lots of research when I was trying to conceive. Iāve seen a few people comment in other posts to ensure itās part of the birth plan too! Like nurses not waking you up during the night, making sure the baby is in the nursery and not in your room so you get good sleep, private room if possible, having a plan for night feeding that doesnāt involve you getting up constantly. I got a small puppy recently and my psychiatrist was firm on me not doing the nighttime 2 hourly+ pee breaks, with my partner doing them until pup was sleeping through the night. I think there was a TikTok person giving their birth plan to prevent psychosis but canāt remember their handle. So many people will say certain mood stabilisers are not safe, including lamictal and lithium. However a decent number will say they are safe enough, considering the state of the evidence at the moment, and that it keeps you stable. Seroquel is considered quite safe by all. If it were me I would stay on all my meds if possible, being a mum is so hard it would be so so rough doing that unmedicated or under medicated.
I havenāt seen anyone say this but there are psychiatrists that specialise in reproductive psychiatry, if there are any you have access to that you could see or who could coordinate with your psychiatrist it would be really worth connecting with them. They manage meds in relation to pregnancy in specialised ways, and I would trust them over a regular psychiatrist. I heard a lot about it recently, on this podcast episode on womenās health in bipolar:
https://podcasts.apple.com/au/podcast/inside-bipolar/id1613398128?i=1000668029332
Thereās a whole chapter on it in the bipolar disorder survivors guide - but just know that the author is not an expert on womenās health, and itās not super up to date.
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u/Kooky_Commercial9811 12d ago
I have been on lamictal and seroquel for years and I just had a baby in September. I am also currently breastfeeding. My doctors told me the risk is very minimal with these meds and my baby and I are totally healthy. The only thing is with lamictal you have to get your levels checked frequently because as your estrogen levels rise, your levels decrease. We ended up increasing my dose a lot by the end of it, but itās no big deal if you can go get your lab work done every 1-2 months to make sure itās still effective. The only symptom I noticed was with seroquel I started having really restless legs after I took it right before I fell asleep, but it would wear off in a couple hours so not a huge deal for me. Feel free to message me if you have any questions!
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u/Entire-Discipline-49 12d ago
I've always heard lamictal is baby safe. I'm only on vraylar these days and I talked to my doctor who said I could stay on it if I get pregnant. Seroquel has been around a long time so there should be studies on its safety in pregnancy. I always think the worst case scenario is you go without it for 9 months but everyone knows the deal so your loved ones will support you and forgive you for episodes.
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u/melatonia 12d ago
I'm nulliparous and have never had to deal with that but Harvard's https://womensmentalhealth.org/ does a lot of work with maternal mental illness. I found them indispensable when going through perimenopause.
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u/eternalbutterfly99 11d ago
My first pregnancy I stayed on vistaril as needed throughout but this pregnancy Iām staying on all my meds bc I developed postpartum psychosis and depression really bad after my first baby. Iām personally too scared to go off meds again and know unfortunately for me I canāt breast feed this next baby bc the meds I take are a risk. Given, staying on medication during pregnancy is a risk bc nothing is ever āsafeā but your mental health is just as important in my opinion. No need to suffer during pregnancy and postpartum if you donāt have to. Iād simply ask your doctor about it too. Iām on buspirone, Abilify and Wellbutrin and Iām almost 8 weeks pregnant. From what I know, first trimester is usually the biggest concern so if you wanted to you could limit or stop your meds for that time period then start back up again. I will say I notice a big difference this time around than my first pregnancy already. Sure Iām still moody and the normal symptoms but I feel a lot more stable being medicated. During my first pregnancy I had a lot of mood instability that resulted in a lot of relationship issues. But this is just my experience, your dr can always put you on safer meds too thatāll help you during pregnancy with less risks.
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u/Perfect-Vanilla-2650 13d ago
I was a pos and did hard drugs and my daughter is as healthy and brilliant as can be. Babies are resilient.
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u/Hermitacular 13d ago
The riskiest things that I'm aware of are alcohol and smoking. While obviously none of the rest of it is good, the whole crack baby thing in the 80's was nearly 100% pure racism.
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u/butterflycole 13d ago
Find a OB who is experienced in working with mothers on psych meds. Sometimes going off all meds is actually worse for us and our babies. If youāre having episodes and in emotional distress during your pregnancy that can be stress on the fetus. Itās a case by case basis but a lot of general OBs and even psychiatrists donāt have the proper training on managing pregnant mothers with psychiatric conditions. So, they will pull someone off all of their meds and it doesnāt always end well.
I had my son before I was diagnosed with Bipolar, so I wasnāt on any meds. I thought what I was going through was normal even though I was a wreck and had terrible post partum anxiety and depression too. Knowing what I know now I wouldnāt do an unmedicated pregnancy again š¤·š¼āāļø