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Avatar universal

On meds, want to start a family in the next year....advise needed!

To make a long story short, I am 32 years old, married and teach elementary school.  I was diagnosed with ADHD as a youngster and was on ritalin until the age of 10.  In high school, I was very moody and had trouble paying attention.  My parents took me to a psychologist who promptly put me on Prozac.  Off I went to college.  Had a couple meltdowns there and received counseling and was put on 2 or 3 different antidepressents. I stayed on Zoloft, tried to stop, got depressed and have been on it since. When I was 27, I went to see a psychiatrist to address my extreme moodiness, depression and anxiety which were affecting my work and social relationships. He put me on Lamictal, Increase my Zoloft and also put me on clonazepam.  Admittedly, I began to feel better and was less moody, anxious and depressed.  I really disliked this doctor after 5-6 sessions and found another psychiatrist who basically kept me on the same meds.  "They" say that I have Cyclothymic disorder.  I have never been "manic" to the extent that I went on shopping sprees or was involved in risky behavior.  I would just be in a really really good mood.  My husband and I want to start thinking about having a baby.  I know I cannot be on these meds while pregant as they all can harm the fetus and lead to birth defects.  How on Earth do I begin weaning off these drugs.  Am I going to totally loose it?  Does this put me at a higher risk for Post-Pardom Depression or Psychosis?  Any advice would be so helpful.  Thanks!
7 Responses
Avatar universal
You would be at a higher risk for pre and post partum depression and psychosis. There are maternal psychiatrists and I would suggest going to one. They can help with the ins and outs of medications.

Do not stop cold turkey. It can cause seizures and if not seizures it will do funky mean things to your brain. I was told by a doctor to quit Effexor cold turkey and that was one of my worst week's ever. This was before they believed in withdrawl for antidepressants so they kept telling me I had a flu. Jerks. But I digress. Tapering down is the best way to go.

I am in the same boat you are. I've started tapering down my antipsychotic and so far so good. I notice that I am not on it, but can tolerate it. It is my intention to stay on the lamotrigine during pregnancy because it is one with few side effects and I feel being sane during pregnancy will help the baby as stress is being implicated for low birth weights and other problems. I've also been told by a psychiatric nurse that the SSRI's are fairly safe after the first trimester.

The other thing I am doing is to become as mentally healthy as possible. I am going to a psychologist to work on establishing balance in my life and doing those things that prevent future attacks. I am trying to exercise more which is the best thing, maybe even better than antidepressants for Mental Health. Eating right is a struggle for me right now but it is on my list of to do's. I am taking omega oil and that really helps. I'm trying to stack the deck in my favor.

You still have lots of time to taper down properly. You'll get there. It will be worth it to hold that baby in your arms. My heart aches for that as I am sure yours does too.
574118 tn?1305138884
After reading similar posts i think this is a personal decision with all the consequences thereafter. I know some stopped the meds cold turkey and no harm done. But if you ask a pdoc he will say don't.  
585414 tn?1288944902
Best to speak to your psychiatrist and when you plan to have a family have them discuss the issue with your OB-GYN about how to proceed at that point.
1039200 tn?1314915608
You really need to get advice from both your pdoc and gyno because there are different options available. Some drugs may be a no-no especially newer drugs that they know less about the effects in pregnancy. You could switch drugs to those that pose less of a risk, or you could stop the drugs for the first trimester when the risk of abnormalities is at it's greatest, or stop altogether. Your options will depend on the severity of your illness / past history and will be a matter of weighing out the risk with your doctors. Any withdrawal must be made under the supervision of your doctor and tapered off gradually.
Being within the bipolar spectrum you have a greater risk of developing post natal depression. I suffered from it myself after the birth of both my children and the second time it led to severe depression with psychosis, this was before I was diagnosed with bipolar and I was given antidepressants which made things worse. It was one of the the worst experiences of my life and I am lucky to be alive  Therefore if I had another pregnancy I would not give up my medication. This is not to say the same thing would happen to you, as we all have our own unique experiences. I wish you the best of luck whatever you choose to do!
Avatar universal
Thank you for your kind words, encouragement and advise.  It's a good feeling to know that others have been through the same thing and everything worked out in the end.  I didn't realize I had so many options.  I will defnitely look into a new PDoc, as while mine is a nice guy, all he really does is write prescriptions. Someone who specializes in this would be a better resource! Exercise, eating well and finding a good psycologist are all such great ideas!  Ones I need to put into action before I even consider tapering my meds.  I would never again stop cold turkey.  I did that once and I spiraled right down to the lowest point I've ever been at.  It's a relief to have others I can talk to about this.  My husband knows but doesn't understand and my sister lucked out genetically!  I want to have a healthy happy baby, but I need to be a happy healthy mom too!  My job is so stressful...I need to find an outlet like exercise to kill the stress while I begin tapering the meds (after talking to my doctor) of course!  Thanks!!
Avatar universal
I've only just come across your post and see that there has been some great advice :D  At the risk of repeating others I'd say definitely find a psych who is informed when it comes to pregnancy.  There are medications that you can take that are considered safe during a pregnancy and eating healthy etc etc makes a difference regardless of whether you are trying to conceive.  It sounds to me like you have you're head screwed on right and that you are approaching this very sensibly.  PPD is more likely because of your mental history but again steps can be taken prior to the birth and immediately after it to help combat this.  I've had 4 babies, had PPD with 3 of them but apart from the first one it was manageable because I was being kept a close eye on and was on correct medication.   Wiith my first baby I hadn't been diagnosed BP at that time and it was an awful experience :(

I have found through trial and error that by having a good sleep routine, eating the right foods and getting enough fresh air that my symptoms are more manageable.  All the best to you and good luck :D
Avatar universal
Perhaps we don't hear from the kids because they have no need to come on here - in other words they have no issues with having a parent with a mental illness, whether that be bipolar, cyclothymia, depression etc etc  There will always be cases where a child's upbringing has not been good but that can be said right across the board, regardless of medical history.

Both my parents have suffered with ongoing severe depression, although there are some elements of my childhood that weren't exactly great, on the whole I had a great upbringing and consider myself very fortunate.

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