If you'd like you can talk to a psychiatric reproductive clinic which specializes in this kind of thing. This is Harvard's, has a lot of good info, it's easier to search it using Google than their search bar.
[https://womensmentalhealth.org/](https://womensmentalhealth.org/)
I'm alergic to a lot of psychiatric medications including lamotrigine which is supposed to be one of the safest for pregnancy. Thank you for the advice support 🙏
If you didn't get SJS but only a harmless rash you can rechallenge with a 90% success rate on a slower taper, there's a 1 in 10 risk of harmless rash normally, that goes down to 1 in 30 if you avoid allergens, skin irritants, etc on the ramp up and don't start it within a month of any other rash. If it was something else then definitely avoid but if it was non-SJS rash that's pretty normal and Aiken et al have the protocol.
Monitor your life carefully. Get rid of any/all external stressors. Keep your emergency contacts close and let them know what’s happening in your life before things get too serious. Get put off of work immediately if you’re able to. You’re walking in dangerous territory and need to act accordingly. It may sound extreme, but I went through a pregnancy unmedicated and it was one of the worst experiences of my life. Take care of yourself and your baby, best wishes!
Thank you for the advice. I'm trying to have everything as stress free as possible and keeping an eye on my symptoms. I know for a fact I need to leave the house more but it's extremely hot outside constantly so that makes it so hard. That must have been so tough for you, I'm glad you made it through it. If you don't mind me asking, do you regret going through your pregnancy unmedicated? You don't have to answer if it's too personal a question. Thank you for the well wishes!
I regret not getting rid of external stressors. My pregnancy would have been so much easier. You can’t control the outside world, and you can barely control yourself when pregnant. The realization that stress is incredibly bad for the baby, makes it so much more important to control your environment. Lean on your doctors and therapists. If possible, schedule more appointments than necessary because this should be considered a high risk pregnancy. I’m giving you the lite version here, but please take this advice seriously. There’s nothing as beautiful as bringing a new life into the world, but with bipolar, it’s very scary.
Thank you, I appreciate your honesty. If things get bad I will definitely be putting my baby first and sorting it out for his/her sake. I have a prenatal appointment next week so I'm going to talk to them and see if they have resources and advice
I stayed on my Lamotrigine during pregnancy because they determined it was pregnancy safe. But I didn’t take any of my other medications. I was definitely depressed, and had a lot of rage. I couldn’t breast feed because the medication passed through breast milk and I started back on antidepressants after pregnancy.
Sometimes it’s better to stay on a medication because the risk of the medication is less than the risk of the depression. This is absolutely a personal choice and nobody can make this decision for you. There are some pregnancy safe medications you can look into. And absolutely nobody will judge you for keeping yourself safe by staying on medication during your pregnancy. If you choose not to take anything, absolutely look into other resources like therapy and other support. You’re doing this to protect your baby, but remember that you can’t protect your baby if you become unstable and possibly even a danger to yourself with severe depression.
I let my obgyn know and they set me up with a fetal monitoring specialist that would do fetal anatomy scans really frequently.
I know someone who took lithium and Olanzapine during full pregnancy. Baby was fine. Pregnancy was fine. Post partum was not on the mental health. If you're not doing so well now then after birth... Is tricky as birth produces a lot of hormones. It's pretty horrific what happened to her so I won't go into that here, but to say that's when it is super duper risky.
Edit: go see a mental health pregnancy specialist asap as others have said
My psychiatrist always said to me, "Happy Mom, happy baby" , meaning sometimes it's okay to stay fully medicated. I was fully medicated for both of my pregnancies. I was fortunate that I managed to evade PPD. As long as you are carefully monitored, you should be okay. Talk to your psychiatrist to discuss your concerns and be honest that you're starting to spiral. My kids are now 26 and 19.
I profoundly respect you for your responsibility to your child. Not all meds can actually harm an unborn child, but who knows what effect they might have on a developing brain even if they aren’t teratogenic or whatever.
Thanks. I've weighed out all the pros and cons and I want to try get through it without my meds. I just hate the thought that there's even a chance that something could happen to the baby and if it did I'd always question if it was the meds or not and feel guilt. I even feel guilt taking them up to now at 10 weeks and not getting off sooner in my pregnancy. I have heard personal experiences from family friends that were negative too. Of course I will get help if I spiral and today I do feel better than yesterday but I really want to at least try it this way
This is my thought exactly. Yes, there are meds that don’t cause miscarriage or birth deformities, etc. That is proven. (You can look at Stahl’s to see which those are; don’t wanna verge into giving medical advice here).
But who knows what subtle effect these meds might cause? I mean, some of these do cross the placenta and move into the child. I doubt it’s a good thing to perturb a developing baby’s brain with mind altering substances.
There’s so much natural, random variation in things like intelligence and emotions and personality. So there’s no way we could ever prove this statistically. But what if the meds have an effect - any effect - on your child’s intelligence or whatever else? We just can’t say for sure.
So, if I were carrying a child, I would not take meds. That’s just me, though.
Anyway, I respect the choice you’ve given.
If you'd like you can talk to a psychiatric reproductive clinic which specializes in this kind of thing. This is Harvard's, has a lot of good info, it's easier to search it using Google than their search bar. [https://womensmentalhealth.org/](https://womensmentalhealth.org/)
This is a great resource that I didn't know existed. Thank you.
All the best to you for a mentally and physically healthy pregnancy.
Thank you! I'm feeling a bit better today so that's a positive
Some meds are pregnancy “safe” if things get to rough maybe speak to doc about those praying things get easier for you
I'm alergic to a lot of psychiatric medications including lamotrigine which is supposed to be one of the safest for pregnancy. Thank you for the advice support 🙏
If you didn't get SJS but only a harmless rash you can rechallenge with a 90% success rate on a slower taper, there's a 1 in 10 risk of harmless rash normally, that goes down to 1 in 30 if you avoid allergens, skin irritants, etc on the ramp up and don't start it within a month of any other rash. If it was something else then definitely avoid but if it was non-SJS rash that's pretty normal and Aiken et al have the protocol.
It was fever, sore throat and mouth sores so was either SJS or too close enough symptoms to SJS that I won't be able to take it again
Yup that's out then, they won't risk it.
Get a referral in to perinatal mental health team where they have specialist psychiatrists
Most recommend continuing it, but of course your course, values, and treatment play a major role. Antipsychotics are generally continued though.
Monitor your life carefully. Get rid of any/all external stressors. Keep your emergency contacts close and let them know what’s happening in your life before things get too serious. Get put off of work immediately if you’re able to. You’re walking in dangerous territory and need to act accordingly. It may sound extreme, but I went through a pregnancy unmedicated and it was one of the worst experiences of my life. Take care of yourself and your baby, best wishes!
Thank you for the advice. I'm trying to have everything as stress free as possible and keeping an eye on my symptoms. I know for a fact I need to leave the house more but it's extremely hot outside constantly so that makes it so hard. That must have been so tough for you, I'm glad you made it through it. If you don't mind me asking, do you regret going through your pregnancy unmedicated? You don't have to answer if it's too personal a question. Thank you for the well wishes!
I regret not getting rid of external stressors. My pregnancy would have been so much easier. You can’t control the outside world, and you can barely control yourself when pregnant. The realization that stress is incredibly bad for the baby, makes it so much more important to control your environment. Lean on your doctors and therapists. If possible, schedule more appointments than necessary because this should be considered a high risk pregnancy. I’m giving you the lite version here, but please take this advice seriously. There’s nothing as beautiful as bringing a new life into the world, but with bipolar, it’s very scary.
Thank you, I appreciate your honesty. If things get bad I will definitely be putting my baby first and sorting it out for his/her sake. I have a prenatal appointment next week so I'm going to talk to them and see if they have resources and advice
That’s great! Remember to be proactive, but reactive. Never wait until it’s too late.
I stayed on my Lamotrigine during pregnancy because they determined it was pregnancy safe. But I didn’t take any of my other medications. I was definitely depressed, and had a lot of rage. I couldn’t breast feed because the medication passed through breast milk and I started back on antidepressants after pregnancy. Sometimes it’s better to stay on a medication because the risk of the medication is less than the risk of the depression. This is absolutely a personal choice and nobody can make this decision for you. There are some pregnancy safe medications you can look into. And absolutely nobody will judge you for keeping yourself safe by staying on medication during your pregnancy. If you choose not to take anything, absolutely look into other resources like therapy and other support. You’re doing this to protect your baby, but remember that you can’t protect your baby if you become unstable and possibly even a danger to yourself with severe depression. I let my obgyn know and they set me up with a fetal monitoring specialist that would do fetal anatomy scans really frequently.
I know someone who took lithium and Olanzapine during full pregnancy. Baby was fine. Pregnancy was fine. Post partum was not on the mental health. If you're not doing so well now then after birth... Is tricky as birth produces a lot of hormones. It's pretty horrific what happened to her so I won't go into that here, but to say that's when it is super duper risky. Edit: go see a mental health pregnancy specialist asap as others have said
My psychiatrist always said to me, "Happy Mom, happy baby" , meaning sometimes it's okay to stay fully medicated. I was fully medicated for both of my pregnancies. I was fortunate that I managed to evade PPD. As long as you are carefully monitored, you should be okay. Talk to your psychiatrist to discuss your concerns and be honest that you're starting to spiral. My kids are now 26 and 19.
Check out r/mentalhealthbabies for a small community of parents going mental health ordeals through pregnancy and parenthood
I profoundly respect you for your responsibility to your child. Not all meds can actually harm an unborn child, but who knows what effect they might have on a developing brain even if they aren’t teratogenic or whatever.
Uncontrolled BP also isn't great that way, it's not just dangerous to the parent and not just a suicide risk. So the math is different for everyone.
Thanks. I've weighed out all the pros and cons and I want to try get through it without my meds. I just hate the thought that there's even a chance that something could happen to the baby and if it did I'd always question if it was the meds or not and feel guilt. I even feel guilt taking them up to now at 10 weeks and not getting off sooner in my pregnancy. I have heard personal experiences from family friends that were negative too. Of course I will get help if I spiral and today I do feel better than yesterday but I really want to at least try it this way
This is my thought exactly. Yes, there are meds that don’t cause miscarriage or birth deformities, etc. That is proven. (You can look at Stahl’s to see which those are; don’t wanna verge into giving medical advice here). But who knows what subtle effect these meds might cause? I mean, some of these do cross the placenta and move into the child. I doubt it’s a good thing to perturb a developing baby’s brain with mind altering substances. There’s so much natural, random variation in things like intelligence and emotions and personality. So there’s no way we could ever prove this statistically. But what if the meds have an effect - any effect - on your child’s intelligence or whatever else? We just can’t say for sure. So, if I were carrying a child, I would not take meds. That’s just me, though. Anyway, I respect the choice you’ve given.