Medications and Pregnancy

  I am 33 years old and have no children. I have been diagnosed with complex partial seizures, asthma, and bipolar II disorder and, consequently take medications. I currently take tegretol, lamictal, wellbutrin, elavil, seroquel, uniphyl, azmacort and alupent. I am considering becoming pregnant and  would like to know what effect these meds can have on a fetus and do i have any options? thank you
  Debi
Dear Debi:
The combination of medical problems that you list will be a challenge to manage during pregnancy. Whenever a patient is under current medical care, it is important that all physicians are aware that the lady is going to attempt pregnancy and that there has been a discussion of both the effects of disease on the pregnancy and the effects of pregnancy on the disease. Many diseases that are active at the time one becomes pregnant worsen; equally, if the disease is well-controlled at the time of conception, management during pregnancy is often much easier.
All antiepileptic drugs, including tegretol, have been associated with a variety of anomalies with a frequency 2-3 times that seen in the general population. The anomalies can be severe, such as spina bifida (spine vertebra misformed).
Lamictal, another anticonvulsant, has a registry wherein patients who have taken the drug during pregnancy are being recorded. 62 reports have been received and the same increased likelihood for anaomalies mentioned above has been observed.
There fhave been no studies of the antidepressant wellbutrin during pregnancy. The tricyclic group of antidepressants, including elavil, are not recommended during pregnancy. Elavil has been associated with malformation of the fetal limbs.
Theophylline has been used widely in asthma and is generally considered safe in pregnancy. There has been a small collection of case reports on cardiovascular anomalies in women taking theophylline, but no cause and effect has been shown.
Azmacort is usually not used in preference of prednisone with which there is greatest experience. Corticosteroids are considered safe in human pregnancy.
Alupent has not been associated with any problems.
Alternative medications to manage a medical condition is a decision that must be individualized by discussion between the treating physician and patient.
Keywords: drugs; pregnancy
This information is provided for education only and is not a medical consultation. If you have specific questions, please consult your physician.