Bipolar and pregnancy

[Shoonasasi]

Please forgive me if this thread doesn't belong here. I felt it was the most appropriate area to post, but mods, please move it if you see fit.

A friend of mine has recently been diagnosed as Bipolar. Her meds were working and she felt so much better, but her and her husband have now decided to try for a baby, and she's gone off her medications (I believe as per her Doctor's advice).

Is there any advice I can offer her for getting through her TTC journey without the help of her meds? I am not sure which medication she was taking.

I believe she would be open to another medication that would be safe during pregnancy, or perhaps a herbal alternative. With all the conflicting advice out there, I felt this forum would be a wonderful place for her to gather information to help her though the potentially difficult times ahead, from people who have been where she is now.

Any information or advice would be greatly appreciated.

Thank you so much.

[CrazyCatLady]

I'm bipolar (among other things) and have been through three pregnancies. Everybody is different of course, but pregnancy is when I'm at my "craziest". Postpartum for me is nothing at all compared to pregnancy.

I was too sick (HG) during my last pregnancy to be on any psych meds. And as a result I spent a majority of my pregnancy in a psych hospital (and before I was locked up there, I was living in my car).

The two pregnancies before that, I was pretty stable anyways at the time. So no meds, but I still had a lot of scary rough patches.

So if she wants to and can make it through a pregnancy/postpartum with no meds, great. But the second she starts to feel "off" or things get bad, she needs to see her doctor about some kind of meds that are decent for pregnancy/breastfeeding. And that might not be so easy. I had a lot of doctors who preferred to keep me locked up rather than try pills, because they didn't think any of them were safe enough to risk even though I was out of my mind crazy at the time. Not that I could have taken them anyways thanks to the ms.

It's never been worse for me then it was during pregnancy. I'm talking self mutilation, suicidal, violent, paranoid, delusional, hallucinations, etc. Nothing that one needs to be dealing with while trying to grow a healthy baby. In some cases iffy meds are better than no meds yk?

Sorry if I sound like a rambly downer. Hopefully your friend will have a much better experience than I did. I wish your friend luck and I hope she has a happy, healthy pregnancy and baby.

[Mom2M]

Lamictal is considered safe for pregnancy and breastfeeding. I take it for other reasons but I know it is a bipolar med also. I've had 2 pregnancies, breastfed my first DD for 4 years and am working on the 1st year of breastfeeding DD #2.
Currently I am on 400 mg/day and during pregnancy it varied as to how much I needed, mostly 300-350 mg/day. I'm not sure what dose would be therapeutic for bipolar.
It takes a long time to get up to a therapeutic level though. With DD#1, I started at a very low dose and it took a few months.
Hope she does well,

Deb

[Shoonasasi]

Thank you so much for your replies. I'm so grateful that you shared your experiences with me. I'll pass the info on to my friend.

[RiverTam]

I mean this with respect, because you clearly care for your friend...

Butt out.

The decision about meds during pregnancy is something that she should discuss with her doctor, and maybe her husband.

There's a huge amount of guilt and responsibility around whether to take psych meds during pregnancy. I really struggled with the issue. Advice from well-meaning friends (who weren't doctors and who didn't know what the heck they were talking about) made my decision even more difficult.

I appreciate that you care about your friend, but this really has to be her decision. I would perceive any advice that you give her, however, well-meaning as pushy and controlling.

YMMV

[Shoonasasi]

RiverTam,

Thank you for your kind concern for my friend's well being, however I am quite careful not to go butting into people's business without seeking their authorization first.

My friend was fully aware that I was posting here, and she was very grateful for the information from the first 2 posters, which I e-mailed her last night. She had not been able to find any reliable information herself, and I told her that the people on this forum were kind and generous with their wisdom and would surely offer advice, which they have.

Not everyone's friends react the way described in your post, and I am terribly sorry your decision was made more difficult by well meaning friends who gave you unsolicited advice. I hope you will be assured by the fact that my friend found my research far from pushy and controlling.

[darling_deedee]

Hey there.

I'm bipolar, too, and I think its rad that Lamictal is safe for pregnancy. I'm on a low dose for depression (75mg/day) and it makes me glad to hear that I won't have to give that up when I become pregnant.

I know that I appreciate advice from well meaning friends who have done their research. The ones that haven't done research, on the other hand, are nothing but a thorn in my side!

-Dee

[RiverTam]

OP, then you should be talking with a midwife or doctor, or at least taking a trip to the library to look for reputable information about drugs in pregnancy. Asking random people on the internet is not a good idea for something as serious as treating bipolar disorder in pregnancy. It's pretty irresponsible to get information that way and then give it to someone else.

Sources to look for at the library:

Briggs, "Drugs in Pregnancy and Lactation"

Davis' Drug Guide for Nurses

Physicians' Desk Reference for Herbal Medecine

[Oubliette8]

I think another thing to keep in mind is that while some women do run into issues during pregnancy, others are able to go off their meds and deal just fine. If she is worried about the effects of the drugs, there is no reason she shouldn't at least give it a try drug free. It might be a good idea, however, to talk with her husband and others in her support system about the possibilities- what does she want to happen if her bipolar gets worse? Can someone help her monitor her symptoms? That might be helpful- often those with mental illness do not realize they are getting worse, so setting up someone as an impartial observer and asking for their feedback can be helpful. It might also be helpful to try a round of therapy during her pregnancy, not only would it be yet another impartial observer, but they could recommend other ways to cope with what symptoms she may have, help sort out pregnancy symptoms from potential mental health symptoms etc. I imagine it might be nice just to have someone univolved to talk to and support her through the time.

[CrazyCatLady]

I wanted to add that since my last post...I've found out I'm pregnant again. I'm not coping with life well at the moment. So if the baby sticks, I've been given a prescription of lithium to try if I feel like it. The only reason they feel ok having me try it this time (and not last time) is because I'm not half as morning sick (at least yet). Apparently lithium, like Lamictal...can make people really nauseous at first. Especially when pregnant.

Hope all is going well for your friend.

[Mom2M]

Congratulations!

I hope your pregnancy goes well and that you can remain stable throughout. Just to let you know, lithium is very contraindicated for breastfeeding so if you plan on breastfeeding you should talk to your doctor about that. Maybe you could try something different if needed.