getting pregnant on meds

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hlayne
Regular Member


Date Joined Aug 2008
Total Posts : 20
   Posted 8/22/2008 8:48 PM (GMT -7)   
I'm wondering if anyone can tell me their experience with taking Lamictal while pregnant.  I've bee reading the literature and talking with my physicians.  There is a risk-benefit analysis that has to be made, I know, but  ?  It's hard to tell.  I know the risk of my depression/ possible Bipolar going untreated.  The risk of taking Lamictal while pregnant is not clear from what I can tell.
 
I have been on several different anti-depressant meds over the last 10+ years, and Lamictal has done wonders for me.
 
Thanks.

serafena
Veteran Member


Date Joined May 2007
Total Posts : 3715
   Posted 8/23/2008 12:13 PM (GMT -7)   
Hi hlayne,

Welcome to HealingWell and to the bipolar board.

I took lamictal while I was pregnant. I also took prozac. We thought long and hard about it first, obviously and did a bunch of research. My psych really recommended I stay on it. She felt I was at great risk for depression if I went off. My obgyn obviously wanted me to stop all meds. I did stop my topomax. We chose to stay on the other meds because we decided the risk of me getting suicidally depressed (which I'd been before) was a much worse, percentage-wise, risk to the baby. At the time (and I can't tell you where we found these figures or I would) we found information which told us the risk of birth defects on Lamictal was around 3 %, which is roughly the same as it is for the general population. (I do remember those figures were British.)

My daughter is absolutely fine. She's smart as a whip (beginning to read already at 3) and beautiful. I was very lucky and had a very smooth pregnancy mood-wise. Obviously I can't promise you the same luck, but I do really encourage you to think of your own health and how that itself is going to affect a developing child. Another option is to stop taking it during the first trimester and then get back on it when you hit the second. Make sure you take a lot of folic acid, too. The folic acid helps counteract the potential damage that the medicine could do.

Good luck.

serafena
Serafena
Co-Moderator, Bipolar Forum
Bipolar II


hlayne
Regular Member


Date Joined Aug 2008
Total Posts : 20
   Posted 8/23/2008 1:28 PM (GMT -7)   

Serafena,

Thank you so much for your input. I've not done this kind of thing online before, but thought I had to try something.  I'm happy for you and your 3 year old daughter.  It's important to hear the good stories just like the bad ones.

I've gotten off Lamictal 200 mg in the last 3 weeks because I've started fertility treatment and wanted to at least try being off it for when I get pregnant.  I was also prescribed Zoloft 100mg/day and Dexedrine Spansules 10mg twice / day, and Ambien 10 mg(regular, not CR) at night.  I'd also gotten off the Dexedrine.

Not the greatest of results.  Cognitively and emotionally I've been declining.  Can't make simple decisions like which dish to use, or where to write something down, and can't do basic math - i.e. figuring out that 20 weeks is abut 5 months took me way too long.

I'm worried I will lose my job before I can pay for the fertility treatment.  That my husband will get sick of taking care of a rather needy, rather fluctuating woman-child.

I did find a good bit of information last night about Lamictal and other meds, their risks, and the risks of untreated depression in pregnant women.   FDA has good stuff, as does OTIS. The latter compiles info about teteratogenic (sp?) effects of various meds- side effects often associated with low folate levels. There was also some good info about how meds are categorized - A, B,C,D and X.  They don't mean good - to bad though - not like a 1-5 scale.  C means there's no evidence of harm in humans, possibly in animals, and possibly jut not enough period

The week before last I asked to start taking Dexedrine again at least on the days between my period and ovulation.  Both docs said okay.  Earlier last week, we increased the Zoloft to 200 mg. (It seems pretty safe until between the 20th and 28th week from what I understand).  Don't know if this increase in Zoloft will make much of a difference. I've had so much more anxiety in the last couple of weeks, however, that maybe it will help control that.

Re Dexedrine - category C - no evidence against it, but not enough known about it either - we're trying for me to just take it between my period and ovulation. It gets out of your system in less than 6 hours.  And I'm on a low dose. The risks do seem to be dose related for Dexedrine. 

The Ambien - category C also - the CR is bad for babies for sure. I'm not sure about this one yet. I've gone back and forth, and it seems like my doctors have also. 

My OB and psychiatrist have been consulted all along the way for the last two year or more.  In the last 3 months I've started seeing a fertility specialist  that my OB referred me to. The OB naturally says no meds are best meds, but there has to be a risk benefit analysis too.  My psych had advised me to get off of the Lamictal (3 1/2 weeks ago) b/c of something he'd recently read about increased chance for cleft pallett (related to decreased folic acid like you mentioned). Then when he saw me yesterday, he told me to go ahead and get back on the Lamictal b/c I can't function. He thinks I need the Dexedrine too - b/c historically the less organized, less competent, more scattered I become the more depressed I become about my inability to function.

 I'm 35, been treated for depression, then ADHD and depression, ongoing sleep difficulties, and now possibly OCD or Bipolar.  I've been on some type of meds since the end of undergrad - around age 21?  And I've tried getting off and changing to the least dangerous, etc.  I've had some success with that - was able to get on a safer sleep med, and I can always use Benedryl as needed.

I'm really thought hard and long about whether it is responsible of me to have a child.  Someone said something about it being a sacrifice for me to go to this much effort - on and off meds in preparation for conception, and then whatever will come with the pregnancy.  I think that it's more selfish, or at least doing what I want to get what I want - a child.  ANd the more depressed I get, the less confident I am in my decision to be a mother - something I never doubted.  The less confident I am in every facet of life.

 

Today, though, I am doing relatively well.  No tears or mopiness.  Still scattered - difficulty concentrating and completing tasks, difficulty w/ the math stuff, etc.  Of course I'm not at work either, trying to accomplish tasks that I typically have no problem doing but lately cannot.  This causes a lot of anxiety.

At this point, my husband and I are thinking that I will try and stay off the Lamictal for as long as I can, and if I start melting down worse, I'll get back on it.  The data I did find on it was unclear as far as how relevant the dosing is to negative effects.  You mentioned staying off for the first trimester and I have thought of it.  I'll be surprised if I dont need it before then though, considering how the last two weeks have been, and how I was last fall before I started the Lamictal, and how I was two years ago after I miscarried.... 

 

So, is there more risk in my getting depressed during the first two weeks and its effect on my pregnancy - or do we go with the unknown risk of taking Lamictal from the get go to avoid the known risk of me depressed.   I don't know whether waiting a couple of weeks to start the Lamictal would be any better than taking it from conception.  Some say once you've been exposed, you've been exposed, so there's no real reason in stopping if you're already on it when you get pregnant.  ?  Since not much is known, then this is probably unknown too. ?



I know that was a lot.  I'll try not to be as long winded in the future. 

Thanks again for sharing your experience and for the encouragement.   A friend of mine tells me to think of all the babies born to mothers on crack, alcohol, nicotene, etc.  And some of the babies acutually come out just fine.  Not that I want to take any of those kind of chances, but, it is a point.  And like you said, the 3% chance of birth defects is within the normal range.  What I read last night was that 3-5% of all women not on meds will have babies w/ birth defects.

hlayne


ddd
Regular Member


Date Joined Aug 2008
Total Posts : 26
   Posted 8/26/2008 8:08 AM (GMT -7)   
ya, you know what??? there's millions of babies born to parents who aren't on medication every day that have problems. Then like your friend said, babies born to crackheads and drug abusers who have 0 problems.... I was on x and drinking and smoking weed around the time I got pregnant and my son is fine so the odds are in your favor... I will say that from my experience, we had always known that there was something wrong with me, but it wasnt till after my son that I realized how deep the rabbit hole goes. The whole experience and postpartum horomone imbalances and the stress of the dependency on me totally set me off and sent me into a place that wasn't good. I was afraid I would hurt him, and myself and just was off the radar so to speak. I would highly suggest to avoid all of that that you are VERY closely monitored while pregnant and VER monitored following the birth if you proceed. I was sooooo calm and happy while pregnant then just lost my mind after. This is not to scare you or be unsupportive, just trying to share some stuff that I experienced in case you were to need it... I think you will be fine and if you are that miserable, you have to take medicine.... I would say this added stress of this decision has to be stressing you out and making symptoms worse so you should make a decision and just hold out faith that everything will be fine and if something went wrong that you made a choice as a human being and that you will do your best to deal with and take care of yourself and your child. You will be okay if you are prepared mentally. Good luck, keep us posted.

hlayne
Regular Member


Date Joined Aug 2008
Total Posts : 20
   Posted 8/26/2008 11:40 AM (GMT -7)   
Hi ddd,
 
Thanks for the input about your experience.  It's becoming increasingly clear that my risk for depression when off meds is quite high, and definitely higher than the unknown risks of most meds I will be taking.  When I found this website last Friday I also found another particularly helpful resource  [www.otispregnancy.org].  Online there were fact sheets about several different medications and their effects on pregnancy. There is also a hotline.  I left a message and a genetic counselor called me back, took down details of particular meds I've been prescribed, as well as a brief medical history.  She called me back after researching details on each med, and talked w/ me maybe 30 minutes.  This was incredibly helpful, informative and reassuring. Here's the information if anyone else would like to look into it.  I think this is okay according to the forum rules ?
 
otispregnancy.org

Texas Teratogen Information Service
(800) 733-4727 or (940) 565-3892
UNT Department of Biology
P.O. Box 305220
Denton, TX 76203-5220
Serves Texas and surrounding areas
open M

-F 9-5 CST
Accepts calls from both public and health care providers
Handles all inquiries

 
 
 
 

ddd
Regular Member


Date Joined Aug 2008
Total Posts : 26
   Posted 8/26/2008 12:08 PM (GMT -7)   
how have you been thinking as far as getting pregnant goes???? I think if you want a child you should have the opportunity that's kinda what we are on earth for lol. but really you just are gonna have to reach a point where you wouldn't regress to questioning your decision and where you would never blame yourself for your moods, where you treat them, and just continue your life.... Isn't this forum like the saddest yet the most neat thing? strangers care yet we all just live in this mass chaos caused by our brains..... Its wild but somedays I just sit on here and wait to talk to people when I feel like Im the only person who does it. Sad huh?

serafena
Veteran Member


Date Joined May 2007
Total Posts : 3715
   Posted 8/26/2008 12:36 PM (GMT -7)   
hlayne:

Thanks for the link. That's a fine link to post -- it's quite helpful.

ddd: I'm sorry you have to wait around for someone to chat with. sad This forum is one of the slower ones on Healing Well. The depression forum, and the Anxiety and Panic forum, while obviously not as (ahem) fabuloso as our forum, do have a lot more traffic. You might check those out too so you wouldn't feel so lonely. Big hugs.

serafena
Serafena
Co-Moderator, Bipolar Forum
Bipolar II


hlayne
Regular Member


Date Joined Aug 2008
Total Posts : 20
   Posted 8/26/2008 8:03 PM (GMT -7)   
ddd -
My thoughts on getting pregnant are that I hope I am right now.  On Saturday I had IUI   - inuterine insemination.  As directed by my OB, I was given some medication earlier in my cycle to stimulate ovulation (to make sure  - no guessing whether I would ovulate and no guessing when I would), then had an ultrasound and a hcg shot two days prior to the IUI.  My husband gave a "sample" to the lab and the doc inserted it.  So, we'll see in a couple of weeks; either I have a normal menstrual cycle or I dont' and I take a test. :-)
 
It's hard b/c fertility issues are well enough known to the general public, but mental health issues are not as known or understood. This is despite the fact that mental illness has been around far longer than the fertility issues that are increasingly common today.  What's hard is that I don't feel comfortable talking with too many people about it in any detail.  And any little comment made results in questions for details I don't want to share. But I open my mouth a little and invite these questions that I then don't know how to best answer. 
 
I feel obligated to explain to my boss at a new job that I'm not feeling myself - i.e. my memory has been horrible!  I forget so, so much and dont' even trust my memory as to whether I really did call this client or whether I faxed this document, etc.  Organization is always a challenge for me, but it's been far worse lately.  My brain has been quite foggy. Then I am dissappointed in myself for my incompetence and low functioning, which leads to depression, which leads to worse performance  - and so the cycle continues.
 
This site has been helpful b/c I can say whatever I want that I really shouldn't say to many others - it just isn't in my best interest.
 
So yeah, this site can be sad but is really great too, I think, b/c there aren't too many other places where you'll find persons with our kinds of experiences, and with our insights, etc. 
 
Maybe in an inpatient psychiatric unit, but we're usually not at our best when we're there. wink
 
So, write, write away.  I'm benefiting from reading what others have written, and from getting to write my stuff out too. 
 
Thanks to everyone for what they share here.
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