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Bipolar Disorder and Pregnancy
By admin | November 12, 2007
Pregnancy is a magical time of every woman’s life. Having bipolar disorder makes the pregnancy harder and future moms to worry a lot. They worry about the medications they’re taking and their impact on child.
Because bipolar disorder emerges during young adulthood and persists throughout the entire life, women of childbearing age are at risk for this illness.
Women should plan pregnancy very careful in order to minimize the effect of the illness on their unborn child. Experts suggest it is important to avoid sudden changes in medication during pregnancy, because changes may increase side effects and risks to the fetus.
MEDICATIONS
A study published in 2001 finds that there is a significantly higher risk of major birth defects when one or more drugs such as Depakote or Tegretol are taken during pregnancy.
The decision whether or not to use medications, particularly mood stabilizers, during pregnancy begins with a risk-benefit exercise in which the patient and her family should be fully involved.
The risks of teratogenicity, posed by all the mood stabilizers, should be weighed against the risks of an illness recurrence, suicide and inability to look after self and the unborn child. If the patient’s previous course of illness has been good with low severity of and frequency of episodes, a planned pregnancy without mood stabilizers may be considered, with a gradual discontinuation of medication and a four week medication-free period before conception.
The immediate post-partum period carries with it a greater than 50% risk of recurrence or exacerbation. Because of this it is advisable to recommend re-instituting mood stabilizer treatment if this had been discontinued earlier. All mood stabilizers are secreted through breast-milk. There is pooled data to suggest that the medication or metabolites secreted through breast-milk do not pose a significant immediate risk to the newborn.
LITHIUM – YES OR NO?
The relationship between lithium and congenital malformations has been under scrutiny lately by new scientific observations. The best known side-effect of using lithium during a pregnancy is probably a specific heart defect, known as Ebstein’s disease.
Another con of the use of lithium during pregnancy is the risk of intoxication with the child. For this reason the newborn, immediately after birth, needs to be examined by a children’s doctor or another specialist. Furthermore, lithium levels should be examined more frequently during pregnancy. This has to do with changes in the amount of body fluids during pregnancy and birth. It is preferred that the intake of lithium is canceled a few days before giving birth in order to prevent problems for mother and child. Also, frequent visits to your doctor are recommended.
BREASTFEEDING
Women who breastfeed their newborns unwittingly give lithium to their children. The baby receives about half the amount of lithium the mother takes in. This is in comparison to mother’s lithium level. However, the child is much more sensitive to lithium. Breastfeeding is not recommended on these grounds. In the case of Tegretol and Depakine, breastfeeding appears to be safe.
Topics: Baby's Health, Family planning/Contraception, Parenting, Pregnancy and Childbirth, Prenatal Care, Women's Health | No Comments »
