Is anyone here?

[thebassomatic76]

If anyone is here, can anyone help me with what mood stabilizers are safest during pregnancy? I have been completely unmedicated since May of last year and am really struggling. I am now 16 weeks pregnant and wondering if I can go back on something. I was taking saphris before my fertility specialist recommended I discontinue it. That was the best working drug I was ever on, out of that, zyprexa, depakote, topamax, and abilify. I was also on topamax and seroquel with the saphris--topamax for migraines and seroquel for sleep. Are any of these medications safe during or after this stage of pregnancy? Are there other drugs that are safer? I dread trying to figure out what to take so I can still breastfeed. There's so little information available about pregnancy or breastfeeding while taking medication for bipolar disorder.

I have also used inderal or midrin to successfully treat my migraines--are either of these safe during pregnancy?

[cpride]

Dear thebassomatic76,

First, it is important to consult your psychiatrist and obstetrician about your current bipolar disorder symptoms to determine if you need medication. If you do need medication, there are medications that are used to treat bipolar disorder during pregnancy especially now that you are past the first trimester. Olanzapine, quetiapine, and lamotrigine have been used without an increase in the risk of premature birth or birth complications. As with any medication taken during pregnancy, there are side effects that need to be monitored for such as weight gain that may result in gestational diabetes, and an increased risk for developing blood clots. You can discuss these risks with your obstetrician. You should use the lowest dose of medication that keeps your symptoms controlled. You should also talk with your obstetrician about taking 4 mg of folic acid daily. For your migraine headaches, the first line medication is acetaminophen that may be combined with metoclopramide or codeine. If you have to use the codeine frequently especially toward the end of your pregnancy, there is an increase in the risk of the baby having withdrawal symptoms after birth. Another medication used for migraines during pregnancy is oxycodone. You can consult your physician to see which medication is right for you. After your baby is born, please contact us that the InfantRisk Center. We can discuss with you the medications you are taking and which ones are safe to use during breastfeeding. Our phone number is 806-352-2519. We are open Monday through Friday 8 to 5 CST. Hope this information is helpful.

Sincerely,
Cindy Pride, MSN, CPNP

TTUHSC InfantRisk Center

[cpride]

Dear Sierra,

Depakote does have the potential to cause birth defects and also complications in later pregnancy. You should seek obstetric care as soon as possible to get off the depakote due to the potential for fetal complications. Your obstetrician and your psychiatrist can work together to decide which medication would be a better alternative for your particular condition. There was only one report of Geodon being used during pregnancy in the scientific literature. That particular baby was healthy. Due to the lack of information, we do not know if Geodon is safe to use during pregnancy. You may consult with your physicians about their recommendations for using Geodon during your pregnancy. There are many medications that are compatible with breastfeeding. Once your baby is born, you can call us at the InfantRisk Center to discuss your particular medications. The InfantRisk Center phone number 806-352-2519. We are open Monday through Friday 8 to 5 CST.

Sincerely,
Cindy Pride, MSN, CPNP
TTUHSC InfantRisk Center