Depakote vs Lamictal

[Ainara]

I have bipolar disorder, did my pregnancy and I'm nursing my 6 week old baby with no meds without problems. I have been able to nurse my kids without treatment in the past (#2 for 27 months and #3 for 8 months) but sooner or later I always relapse.

My med of choice is Seroquel, however since we are cosleeping with the kids that one is out of the question. I've used Lamictal in the past and it has somewhat helped me, but i haven't felt complete relief (like I do with Seroquel),

I'm thinking since I had my tubes tied (so no chance of an accidental pregnancy) maybe I could try Depakote, I have Dr. Hale's book ('10 edition) and I know the AAP says valproic acid is compatible with breastfeeding, but how does it compare to Lamictal? Is one safer than the other?

[admin]

Ainara:

I would not suggest Depakote (Valproic acid). We've known for a long time that it probably causes spina bifida, now new evidence shows a dramatic drop in IQ in infants exposed during pregnancy. Since the brain is still growing during breastfeeding, I'd suggest it is a poor choice for a breastfeeding mother.

The levels of Seroquel in milk are very low, and it is suitable. Lamictal is also a good choice, although levels in milk initially are high postpartum. But it is commonly and safely used in many moms.

Tom Hale Ph.D.