I have severe bipolar and am 12 weeks
pregnant. I was diagnosed with bipolar at
the age of thirteen although all the
psychatrist's I have seen think I have had
it since I was a small child. I am now
thirty one years old so I have had to deal
with it all my life. The pregnancy was a
total shock as I have endometriosis and
have not used protection in ten years so I
thought I was infertile. Anyway, I had to
go off all of my medications as soon as I
found out I was pregnant at 5 weeks. I
was on lithium, amitriptyline, and celexa.
I have been progressively getting worse
and worse. I have been having severe
mixed episodes but the mania is worse. My
doctor said I could take the celexa for
depression but it has increased my mania
even more. I really need my lithium but
of course cannot take it due to the birth
defects it causes. I am a very angry
manic so I am either angry and/or upset a
majority of the time. The anger causes
physical symptoms as well like tension in
my head, neck and jaws. I rarely sleep
and when I do I have angry frustrating
dreams. When I wake up my jaws are
killing me from clenching them. I easily
go into rages and destroyed the house once
so far. I cannot control it and calm
myself down. It is very rare that I am
calm and content. I am so miserable! I
am very worried about how my emotional
stress is affecting my baby. Are there
any bipolar mother's out there who have
been through a horrible pregnancy? Did
your babies turn out okay? Is there
anything I can do for myself? If anyone
has any advice or comments I would greatly
appreciate it.
the first 12 weeks are particularly
critical for a developing foetus (not that
things can't go wrong later, but...).
Have you discussed this with your
prescribing doctor? Explored all
options? Does a night guard help with
your jaw?
At first glance, it looks like heart
deformities are the biggest concern.
Good luck, and remember that the second
trimester is usually when women feel
great. Nausea gone, skin & hair
lovely, energy back (no more falling
asleep anywhere & everywhere). The
last trimester is the toughest, overall.
|
DSmith529
Experienced User , Rather EHEALTHy
Joined: 18 Oct 2005 Posts: 59
Hot Off the Press! Posted: 05-25-06 11:57am
Prophylactic treatment of bipolar disorder
in pregnancy and breastfeeding: focus on
emerging mood stabilizers
author: gentile, salvatore
source: bipolar disorders, volume 8,
number 3, june 2006, pp. 207-220(14)
publisher: blackwell publishing
abstract:
gentile s. Prophylactic treatment of
bipolar disorder in pregnancy and
breastfeeding: focus on emerging mood
stabilizers.
bipolar disorders are reported to have a
high incidence during childbearing years
and the need may arise to start or
continue a pharmacological treatment
during pregnancy and the postpartum
period. In the last few years several
investigations have evaluated the efficacy
of emerging mood-stabilizing agents in the
treatment of bipolar disorders, such as
lamotrigine, olanzapine, risperidone,
quetiapine, aripiprazole and ziprasidone.
A number of studies, which examined the
use of oxcarbazepine, point to its
potential usefulness in prophylactic
treatment. The aim of this review is to
compare information from the literature on
the safety of lamotrigine, oxcarbazepine,
risperidone, olanzapine, and quetiapine to
the safety data on classic mood
stabilizers during pregnancy and the
postpartum period. Methods:
a computerized search carried out from
1980 to april 5, 2006 led to the
summarization of the results. (references
were updated after acceptance and prior to
publication.) results:
emerging mood stabilizers show uncertain
safety parameters in pregnancy and
lactation. Limited information on
lamotrigine and oxcarbazepine does not
suggest a clear increase in
teratogenicity, while olanzapine appears
to be associated with a higher risk of
metabolic complications in pregnant women.
Data about risperidone and quetiapine are
still inconclusive. Finally, the
literature on the safety of these
compounds in breastfeeding is anecdotal.
Conclusions:
untreated pregnant bipolar women are at an
increased risk of poor obstetrical
outcomes and relapse of affective
symptoms. On the other hand, classic
antiepileptic drugs are well-known human
teratogens, whereas data on lithium are
partially ambiguous. The safety of
emerging mood stabilizers in pregnancy and
breastfeeding has not been examined
extensively. Therefore, when approaching
bipolar disorder, if possible, each
episode must be considered separately.
Keywords: antiepileptic drugs; atypical
antipsychotics; bipolar disorder;
breastfeeding; mood stabilizers; pregnancy
document type: review article
doi: 10.1111/j.1399-5618.2006.00295.X
|
MysticalStar
New User, Becoming EHEALTHy
Joined: 24 Aug 2005 Posts: 24
I Will Be 13 Weeks On Sunday Posted: 05-25-06 12:59pm
Thanks so much for all the information.
I have discussed my options with my
psychiatrist as well as my obgyn. They
have both told me basically the same
thing, I can take my antidepressant but
that is all. Unfortunately it is the
mania that is driving me crazy and taking
an antidepressant makes it worse. I
cannot take any meds for the mania because
all of them are too dangerous for the
growing fetus. So my doctors said all I
can do is talk to a therapist, family
member, friend, etc. About how i'm
feeling. It actually makes me worse to
discuss my feelings because it just gets
me even more worked up. So I will have
to struggle through this pregnancy with no
help from medications. I really would
not want to risk taking meds anyway.
What I have most been concerned about is
my baby. I fear that, due to my
emotional turmoil, I will have a preterm
baby or my baby will come out angry and
cranky. I just wonder what affects my
emotional status will have on my growing
baby. I haven't been able to find any
concrete studies on how babies are
affected by their mother's emotions. I
am more worried about that than about
myself right now. :(
|
DSmith529
Experienced User , Rather EHEALTHy
Joined: 18 Oct 2005 Posts: 59
Quick Pubmed Search Turns This Up. Posted: 05-25-06 14:04pm
: j child psychol psychiatry. 2000
sep;41(6):747-57. Related articles, links
maternal depressive symptoms affect infant
cognitive development in barbados.
Galler jr, harrison rh, ramsey f, forde v,
butler sc.
Center for behavioral development and
mental retardation, boston university
school of medicine, ma 02118, usa. Jgaller@bu.Ed
u
this longitudinal study is part of a
series examining the relationships between
maternal mood, feeding practices, and
infant growth and development during the
first 6 months of life in 226
well-nourished mother-infant dyads in
barbados. In this report, we assessed
maternal moods (general adjustment and
morale scale and zung depression and
anxiety scales), feeding practices (scales
describing breast-feeding and other
practices associated with infant feeding
in this setting), and infant cognitive
development (griffiths mental development
scales). Multivariate analyses, with and
without controlling for background
variables, established significant
relationships between maternal moods and
infant cognitive development. Infants of
mothers with mild moderate depression had
lower griffiths scores than infants of
mothers without depression. Maternal
depressive symptoms and lack of trust at 7
weeks predicted lower infant social and
performance scores at 3 months. Maternal
moods at 6 months were associated with
lower scores in motor development at the
same age. Although no independent
relationships emerged between feeding
practices and infant cognitive
development, the combination of diminished
infant feeding intensity and maternal
depression predicted delays in infant
social development. These findings
demonstrate the need to carefully monitor
maternal moods during the postpartum
period, in order to maximize the benefits
of breast-feeding and related health
programs to infant cognitive
development.
Pmid: 11039687 [pubmed - indexed for
medline]
you could do worse than spend a couple of
federal dimes (toll-free number) and call
nimh directly. I'm not seeing that
lithium is completely contraindicated,
particularly later on in the pregnancy.
Hmm, I would also call nichd too.
Perhaps there is some ongoing clinical
trial(s) and/or more up-to-date
information.
I really appreciate the time you spent on
providing this information. It is really
hard to decide which is the lesser of two
evils. Medications and emotional stress
both affect the fetus so it is a tough
call. When I mention lithium to my
doctor's they both say "no way, too
risky". So I am no doubt between a rock
and a hard place. Thanks again for all
your help. I will definitely look into
the info you gave me.
