Lamictal or Zoloft?

[namdrow]

I was on lamictal and zoloft for bipolar/anxiety in early pregnancy, then took myself off of them for various reasons (not doctor approved). I am now 25 weeks pregnant. Lately the doctor has been quite insistent that I go back on them but I am really nervous about adverse effects on baby. Is one drug safer than the other for pregnancy and breastfeeding? I realize they do different things but I am just trying to get through this pregnancy/breastfeeding period after which I will go back on both.

[Sandra]

Lamictal or Zoloft

Namdrow thanks for posting,

Zoloft is given a rating of P3-unknown, risk to the fetus cannot be ruled out. Studies show that the use of this drug in pregnancy does not increase the risk of congenital malformations. The infant could have withdrawal symptoms after delivery so should be monitored closely for 48 hours and mom should be encouraged to breastfeed to help prevent or lessen the withdrawals symptoms. A study has shown that if infants are exposed to SSRI prenatally alone or prenatally and postnatally via breast milk have blunted response to pain as compared to control infants.

Lamictal is also given a P3-unknown, risk to the fetus cannot be ruled out. Lamictal does not appear to cause major congenital anomalies, but one drug registry found a slightly increased risk of cleft lip and palate. Folic acid supplementation is recommended prior to and during pregnancy when taking lamictal. As with all medications should only be used during pregnancy if the benefit to the mother outweighs the risk to the fetus. The effect of lamictal on labor and delivery in humans is unknown.

We recommend discussing all medications with your OB prior to use. I hope this helps, if you have any other questions please call the InfantRisk Center at 806-352-2519. Thanks,

Sandra Lovato R.N.
InfantRisk Center

[namdrow]

Seroquel?

Thank you so much for your response.

What is the latest on Seroquel, particularly at a very low dosage (25?) That is the other medication I am considering. I am having a lot of anxiety about taking the meds so in order to get me the help I need, I may need to take something that will give me some fairly immediate relief, which I know seroquel does.

Right now I am thinking take the seroquel until it calms me down enough to take the lamictal, take the lamictal for the rest of the pregnancy, then switch to seroquel to breastfeed...

[Sandra]

seroquel

Namdrow,

Seroquel is rated P3, unknown, risk to fetus cannot be ruled out. No apparent increased risk of congenital anomalies in a small number of studies. (Koren, Tenyi, Taylor, McKenna, Gentile) Risk of maternal weight gain with subsequent increase in diabetes mellitus and thromboembolic events and neonates large for gestational age. (Koren) In a study conducted on the use of atypical antipsychotics during late pregnancy, it was found that Quetiapine had the least amount of passage through the placenta compared to other atypical antipsychotics (i.e. olanzapine,haloperidol, and risperidone).

I hope this helps, if you have any other questions please call the InfantRisk Center at 806-352-2519. Thanks,

Sandra Lovato R.N.
InfantRisk Center

[namdrow]

Thanks! Do we have placenta passage comparison between seroquel and lamictal and zoloft?

[Sandra]

namdrow ,

I do not have any information about how much crosses the placenta for any of these medications, sorry.

Sandra Lovato R.N.
InfantRisk Center