Pregnancy talk with pdoc

[Skims]

So here is what I learned from my pdoc. This is a long one, I hope you read it or at least the 1st part.

In his opinion if I were to decide to get pregnant I should stay ON my meds. Not all of them just the main ones. Those being my antipsychotic, and 2 antidepressants. He said that the risk of stress during pregnancy outweighs risk of taking meds to the fetus. Stress causes birth defects and developmental delays. Wellbutrin is very safe during pregnancy and while breastfeeding, Zoloft is okay (although I’m taking the max dose) will cause withdrawal in baby and I’m not sure about breastfeeding (got conflicting info from pdoc and what i read on internet). The lowest risk AP to take is Seroquel and my med is in the same class of drugs as that (Saphris) so its safe to take while pregnant. As for breastfeeding with the AP, well… he said no, if you are taking Saphris. I was super disappointed about this. He said most of his patients have bottle fed. Just found this:

Among 21 antipsychotic drugs used in clinical practice, for 7 there are no data at all regarding breastfeeding and for 6 others the data are based only on few infant exposures. Only few prospective studies assessing’use of haloperidol, chlorpromazine and olanzapine during
breastfeeding were identified. Olanzapine and quetiapine were categorized as acceptable for breastfeeding. Chlorpromazine, haloperidol, risperidone and zuclopenthixol were categorized as possible for breastfeeding under medical supervision. Breastfeeding cannot be currently recommended for the following medications: aripiprazole, asenapine, chlorprothixene, clozapine, droperidol, fluphenazine, flupenthixol, iloperidone, lurasidone, paliperidone, perphenazine, pimozide, trifluoperazine, thiothixene and ziprasidone. NCBI Antipsychotic drugs and breastfeeding.

I asked about Titrating down at 28 weeks and stopping meds before the birth, so baby doesn’t have withdrawals and so I can breastfeed and bond better with it. He didn’t recommend this because as soon as the baby is born the mothers progesterone goes from 38000 to 0, and that can trigger depression or psychosis.

So with all that being said, on a more personal note. I had invited my bf to come to the pdoc appt. I wanted him to meet the pdoc and ask questions. He declined, said he felt he didn’t need to be there. I think he felt this way because this was only our 1st conversation about babies and he got scared that I was jumping right into having one. LOL. I’m just thinking about the future, like in a few years. The 1st question out of pdoc’s mouth was were was the bf! HAHA. We also talked about other things like my support system, if my parents would be helping or his parents. I said my parents would help when its convenient for them (I can’t see my dad changing diapers) and I’m not sure I would want much help from them as they are toxic, and the bf’s parents are much older I don’t think they could physically help much. We talked about what would happen if I needed to be hospitalized during the pregnancy and after birth and how that would affect the baby, myself and the bf. It was a very interesting and informative conversation. He didn’t just lecture me, we really discussed my options. I’m really proud of myself for bringing up the topic with the pdoc.

When I got home I reported everything that was said back to my bf. He said “See, I knew you could do it all along.” Even though this eases some of my worries about the technicalities of pregnancy, what about all the other fears? Having a child while having a mental illness… The fact that they have a 13% chance of developing sz (if I understood the data correctly). I mean I look at my mom, she said to me once she tried to be the opposite of her mother when it came to parenting us. I guess she did a little better… But she fell into all those same traps her mother did. They both had so little insight.

I also told my bf that this was all “putting the cart before the horse.” He just looked at me, I stared him down. He got all blustery, LOL. We’ve never had the marriage talk either, or rather how-do-you-see-us-in-the-future talk.

[anon24015320]

Hope he’s a goodun
X best to you

[HC15]

I am currently 7 months pregnant and suffer from depression that is well-managed with medication. I am on celexa, an SSRI medication and both my psychiatrist and OB are more than comfortable for me to stay on this category of anti-depressant. I can’t speak for anti-psychotic drugs however since I am not prescribed this category. This is not my first child, and with my first, it was prior to diagnosis, so I was unmedicated. That pregnancy was a lot harder than this has been. My baby was born overdue and of low birth weight, which could be attributed to the depression/stress I was under at the time. He’s a healthy 5 year old now. My unborn is doing well and all the ultrasounds have been normal. No birth defects.

My psychiatrist and I discussed side-effects at length for about a year before I got pregnant with baby #2. He was pleased that I raised the topic with him before getting pregnant. Most people apparently wait until after in order to discuss medications. He even sent me for a consult with the director at our local teaching hospital’s Center for Women’s Mental Health where they specialize in reproductive medicine and psychiatry. This Dr gave me quite a lot of literature on the subject of anti-depressants and pregnancy. You may find that there has been alot of research carried out (mostly in Sweden) over the past decade about the affects of anti-depressants on newborns. In this literature, there is believed to be a slightly higher risk of newborns of mothers on an SSRI developing a breathing issue at birth known as Persistent Pulmonary Hypertension. I gleaned that from what my own doctors informed me and also from the wide range of literature on the subject that he gave me to read. If you do choose to research, my advice is to stay away from sensationalist media/law-suit type articles on the subject that tend to have ulterior motives. My SIL tried to push that kind of material in my face and I politely said I was preferring the advice of my drs, who are more qualified to give advice. The scholarly articles in psychiatry journals are less sensationalist. Here’s a link to one of the articles I received from my dr that you may/may not find helpful.

http://www.bmj.com/content/344/bmj.d8012.full

I tried breastfeeding with my first child and lasted a couple of months, but he was born tongue-tied and it wasn’t picked up at the hospital, so there were other factors compounding my decision apart from the depression. As much as I wanted to breastfeed, and was rather devastated when I couldn’t find success, my son has turned out just fine on formula. I’d like to try breastfeeding again with my next baby, but am still undecided. I will be continuing on my medication and whilst the amount of medicine detectable in breastmilk is minimal for my particular drug, I see no point in forcing myself into feeding that to my child when formula is a perfectly good alternative. I find too that having all of the feedings to share with my husband (and even my now 5 yr old) will help us all bond with baby. There are pros and cons to both really given your particular circumstances.

As far as your fears of your child developing sz, try to push that to the back of your mind. Whilst the incidence may be higher in families with a history, it’s not a given. My father has sz and my mother, bi-polar/BPD and I have neither of those illnesses. I’ve seen others comment on this site that even among twins, one could have sz and the other, not at all. Environmental factors are also said to play a role.

All the best. I hope I was of help without seeming as though I am pushing my agenda on you. I’ve had personal experience with this and also have friends of mine who have gone on to have healthy pregnancies and newborns whilst on SSRIs. As I said, I can’t speak for other classes of drugs however.

Good luck!