Questions for Pregnant Moms who take Bipolar meds (Lamictal)

[soccerchic21]

Hi All!

My husband and I are going to work on conceiving our third child and we are very excited. However, this is the first time I will be pregnant while possibly taking medication for mild bipolar mood disorder.

Currently I am taking 200mg of Lamotrigine (Lamictal) and 25mg of Sertraline (Zoloft). My OB is sending me to meet with a high risk OB for a pre-conception appt to go over my medication and side affects or possible risk to a fetus. I do have a friend who took Lamictal while pregnant with her fourth because she has epilepsy and he is very healthy. I just get nervous with any risk. There is a risk for spinal/neuro defects.

I am pretty nervous. I don't want anything to affect a baby that I am carrying. Right now I am thinking because my disorder is classified as mild and I have never been hospitalized or attempted suicide that I will be fine with going off of my medication for a pregnancy. My psychiatrist said he wouldn't be against it and I trust his judgment.

Has anyone gone through this? I stopped taking my Klonopin (Clonazepam) for mild anxiety because it can cause a cleft palette. I am doing pretty well which is good news.

Anyway I was hoping someone had a similar experience and could share.

Thank you!

[sharr610]

I don't have any experience personally, but a dear friend of mine was on bi polar meds with her first. When I was on Wellbutrin with #1, she referred me to this site for the latest in some great NIH sponsored studies on the issue http://www.emorywomensprogram.org/

Hope you can find some good info there! And best of luck with your pregnancy!

[angela1435]

I am on Trileptal for this pregnancy. It is also an anti seizure drug but I use it for bipolar. I saw a maternal fetal medicine specialist and he explained it this way to me. There is a higher risk for taking the medication but normally the risk is 1 in 10000 and with taking it it may rise to 1 on 5000. Which is still good odds. To me it was worth the risk to feel ok during the pregnancy. But it's something you have to decide for yourself. I also am on Zoloft which I'm sure you know is pretty safe during pregnancy and breastfeeding.

I hope you figure out what is right for you. I know how hard these decisions are. :

[xixstar]

I started taking lamictal during the second trimester. I'd been med free for several years because I'd learned to manage my moods with consistent diet, sleep, and exercise. Unfortunately, I found that being pregnant with a still-nursing (at first) 13m old and general life stress -- that I couldn't keep up with everything I needed to do to manage my bipolar without meds and finally admitted that I had to take meds again.

So I did the research and decided to go back on lamictal at 100mg a day starting in the second trimester. It's worked well for my moods -- a higher dose would probably work a little better, but 100mg keeps me balanced enough. I see a homebirth mw, so I've not done any extra testing or any ultrasounds, so we'll know in the next few days/weeks if there has been any negative side effects -- though most of the reported ones were related to first trimester treatments at higher doses.

Personally, at the point you're at now, I'd see about reducing or stepping off your meds while working with your doctor. I found that making sure I ate on a consistent schedule, slept on a consistent schedule, and hit the gym at least 3 days a week - I was able to manage moods just fine. I'd still have some ups and downs, but they were very mild and manageable. I did all of that while working with my doctor as well. But testing the waters before you have pregnancy hormones throwing a wrench in thing would probably be a good idea if you're considering that track.

[soccerchic21]

Thank you for your input Karen. Your situation sounds similar to mine. My doctor did say he thinks that I would be fine going off of it for the first trimester then returning after that. I do need to make an appt to see a maternal fetal specialist too. I decided I will wait to speak with them before actually getting pregnant.

Plus we are going to Disneyland in June! LOL!

[soccerchic21]

Thank you Angela! The way it was explained to me was the risk was also low for the medication I am on. It is good to know that there are other people in the same boat I am in.

[soccerchic21]

Thank you for that link it is very imformative.

[loonar]

I took Lamictal for bipolar for about five years. Under the advice of my psychiatrist, I tapered off in January in preparation to try to conceive our first. Instead I have been taking very high-dose fish oil, which has been shown in preliminary studies to be an effective treatment for mood disorders. So far my mood has been pretty stable, and I'm happy with the decision. I have developed a strong support network and good coping mechanisms, so I feel confident that if I started to have problems I'd be able to get the help I needed.

Obviously it's a very personal decision, and will depend on your own circumstances and your own experience with the disease.

[soccerchic21]

Thank you for reminding me of that. I have heard that about fish oil. I am very thankful that I have an amazingly supportive husband who has been my rock through all of this from the beginning when I had horrible post pardom depression with my second.

I have also developed good coping mechanisms over the past year which has been incredibly helpful.

I think after sitting on this it is better to be patient and talk to a few drs about medication and wait a few months to conceive.

[xixstar]

Originally Posted by soccerchic21

I have also developed good coping mechanisms over the past year which has been incredibly helpful.
.

this is a huge plus in your favor as well. I'd also done many years of therapy and had much better coping mechanisms in place by the time I stepped off my meds. I also had a very supportive partner that would help point out when my moods were getting off -- as in, suggesting some time outdoors (always a plus for me), reminding me eat or get extra sleep, or other solutions that would have a positive impact on my mood, along with just point out that I was feeling overwhelmed and that things were actually okay.

You mentioned anxiety as well and I've been pretty pleased with Rescue Remedy when I get very anxious or cranky during the day. I think that was one of my first steps into more holistic approaches to my health, and now I'm really into using aromatherapy and prepping to encapsulate my placenta for easing any PPD as well... it's amazing how some little step can send us further and further on a "crunchy" trail.

[soccerchic21]

Originally Posted by xixstar

I'm really into using aromatherapy and prepping to encapsulate my placenta for easing any PPD as well... it's amazing how some little step can send us further and further on a "crunchy" trail.

The news in Seattle did a report on this a few months ago. I think it is an amazing idea and makes complete sense. I will probably look into costs for this as well. Anything to ward off the baby blues is a real plus.

I was recommended rescue remedy by a client who was taking up a lot of my time a few years ago. LOL!

[rparker]

I've never taken Lamictal, but I am diagnosed bipolar. The only medication I was on prior to conception was Zoloft. I decided that (for me) the risks to the fetus outweighed the benefits, so I quit it during the first trimester... which was really hard to do combined with morning sickness. You may decide to remain on Zoloft, but if you don't I recommend quitting it before becoming pregnant. Zoloft is (mood-wise) really hard to stop taking.

My moods actually improved with pregnancy and remained relatively ok postpartum, which I guess can happen for some people. I never went back on medication postpartum, although I did seriously consider resuming Zoloft.

If you do decide to quit one or both of your medications during pregnancy social rhythm therapy might help. The book my psychologist recommended can be found here.

Both Lamictal and Zoloft are relatively breastfeeding friendly, which is great. A lot of other common bipolar medications aren't.

[Sleepymama]

It's been a long time since I've been to MDC but I came looking for exactly this information. We are thinking about TTC #3 and am finally in a mental zone where I think I could do it. But I have a history of birth defects (DS has a severe heart defect) so I am concerned. However, I didn't take anything with him, did take a small dose of cymbalta with #2 (I was already taking it when I got pregnant with her) and that pregnancy was awful, psychologically and physically. But she was 100% healthy, go figure. I have been taking lamictal for about 2 years and it has been really great for me. I have tapered off antidepressants for the first time in years. I wasn't diagnosed BP II until after DD was born. I could try to go off the lamictal too but I'm afraid I'd crash, so I'm glad to know that it seems to be OK.

I hope, since this thread is a few months old, that you are all having healthy pregnancies!

[ChristineEileen]

Wow, thank you Sleepymama, for finding this thread! I was dx'd bipolar in 2007, and it's been a gradual process to get to this healthy head-space that i'm happily in now. I take Lamictal, and had talked it over with my PA before ttc. Thanks for the info, I appreciate being able to learn more about pregnancy & meds.

[soccerchic21]

I completely forgot to come back here and post an update! I am now almost 13 weeks pregnant and still taking my Lamictal. I went and saw a maternal fetal specialist and he said that Lamictal is very healthy and one of the safest bi polar medications to be on which was reassuring. I am taking extra folic acid as well.

So far so good! I had a first trimester u/s for my screening today and the tech said the spine looked good as well.

[myk]

i'm taking lamictal for seizures, 150mg twice a day. it does interfere with folic acid metabolism so it's a good idea to take 5mg daily. it has not been associated with neural tube defects, but it has been associated with cleft lip/palate - the risk can be reduced by taking the extra folic acid. my psych and my obstetrician both said to keep going with it during pregnancy

zoloft is an SSRI, which in general aren't associated with birth defects. the benefits outweigh the risks in many cases. i took effexor (an SNRI) during my first pg with no problems, i'm taking celexa with this one. again, psych and OB both say keep going with it.

my sister took lamictal for seizures throughout her pg and her son is perfect