I have been asked on a number of occasions about bipolar and pregnancy and I can only say that I was already 4 months pregnant when I was diagnosed with bipolar. Because of the pregnancy I refused to take medication and although the pregnancy was a sheer nightmare I would do it all over again.
I strongly advise that if you are bipolar and you wish to start a family or add to your family, that you talk to your health professionals and ensure you receive extra support, as I found bipolar and pregnancy difficult.
I do not know if medications for bipolar are safe to take during pregnancy, I am not aware there are any proven facts either way, all I do know is you need to weigh up the options for you personally. Could you cope without your medication?
Being bipolar and pregnant is an extra stress and it is never to be taken lightly. I suffered severe mood changes, partly due to the increase in hormones. I was assigned a psychiatrist who worked with bipolar and pregnant patients.
I did have a terrible pregnancy and the anxiety was extreme. You can read about my own bipolar and pregnancy experience here on the blog in the living with bipolar section, but please bare in mind that I was diagnosed at this time.
Would I have more children? Yes I would. Would I take bipolar medication during pregnancy? No, I would not but that does not mean that you should follow my example.
Bipolar and pregnancy can cause complications with your treatments as many women choose to stop taking their medications from fear of them harming their baby. This of course causes risks to the mother to be. But I do believe with careful planning that a bipolar pregnancy can be an enjoyable one, without much disrupt on your mental health.
Since Depakote is a substance proven to have harmful effects on foetuses, many experts recommend that women switch to another mood stabilizer before conception.
For many people, lithium is a mainstay of their treatment for bipolar disorder. The decision to continue taking lithium during pregnancy can be lifesaving to the mother. Other women might switch to lithium because it has fewer risks to the developing foetus than their current medication.
First-generation antipsychotic medications continue to play a major role in the acute treatment of mania. Since they have a longer history of use than many mood stabilizers, their effect on pregnant women is better documented. Some health care professionals suggest that a woman’s medication be switched from lithium or an anticonvulsant to a first-generation antipsychotic medication for either the entire pregnancy or the first trimester.
Few studies have been reported on the use of second-generation medications during pregnancy. Several second-generation antipsychotic medications have not yet been approved for maintenance therapy for bipolar disorder, including Seroquel (quetiapine) and Risperdal (risperidone). Early studies indicate that Zyprexa (olanzapine), which has been approved by the Food and Drug Administration (FDA) for the treatment of acute mania, is not associated with birth defects. However, Zyprexa has been associated with weight gain, gestational diabetes, and high blood pressure. Weight gain, blood sugar levels, and blood pressure should be monitored carefully in all pregnant women taking Zyprexa.
Difficulty sleeping and anxiety are powerful triggers for the recurrence of episodes in bipolar disorder. Tranquilizers and sedatives, which help to regulate sleep, may reduce the risk of episodes during or after pregnancy. Medications that stay in the body the least amount of time are preferred. Sedatives and hypnotics are excreted in breast milk, but there have been few reports of complications due to their use.
When used in women who are pregnant, ECT may pose fewer risks than untreated mood episodes or treatment with medications known to be harmful to foetuses. Complications of ECT during pregnancy are uncommon. (Managing Bipolar and Pregnancy)
I personally did not take medication and had therapy in a talking manner with both my psychiatrist and community psychiatric nurse for the duration of my pregnancy.
I did have to remain in hospital for 5 days after giving birth in order that the mental health team could asses me before I was allowed home.
Bipolar and pregnancy can live together, there is no reason why a women with bipolar should not have a family, but only you know if you are ready or able to start a family and it is never a decision that should be taken lightly with or without being bipolar.