lamictal and pregnancy

[Malaksharif]

hi guys

i have not been well lately as am reducing lamictal and was on 75 til yesterday,then after i saw my pdoc he made me go on 100 till i stabilize again as he would not let me become pregnant while am depressed


he is trying to convince me that lamictal is absolutely safe during pregnancy and i will not be able to be medfree as i cannot take it


any thoughts or experience till i search it further
thx

[paranoid_cataclysm]

Well one of my aunts has bipolar disorder and was pregnant before but she doesn't use the computer that I know of.  I don't know many details except while pregnant it was the only time she hallucinated in her life.

[Malaksharif]

why every time i post anything about pregnancy or child care no women answer me,only men!!!!

no one here got pregnant while bipolar???????all decided not to have kids after diagnosis?????

i found other forums talking about lamictal and pregnancy and lots of women are participating but with epilepsy ,,no one with bipolar?????????

where are you guys??

[paranoid_cataclysm]

No problem.  Best thing to do is research on any medicine before you take it, even physical ones although I think people don't worry about them as much because they aren't generally affecting your brain which is the one organ most people are the most touchy over being tampered with or can mess up their unborn child for example.  One of the very hardest things for me is putting the first dose of a new psych med in my mouth and swallowing and yet it's supposed to be so easy to do.  Don't fall into the trap of stopping your meds on your own, always try to follow your psychiatrists dosing instructions.

[Malaksharif]

thank you so much all for your support and info,,,,,,,,,,,,,,,,,,,am sure have to search it more

please pray for me to have the courage to go on as there comes days when i feel i cannot do it................as it seems that i must go medfree

[adel_ezz]

Thanks

Oh God, this needs a specialist to decode .

breastfeeding is no problem because there are alternatives

thank you for your kind help

[ILADVOCATE]

Thanks but those sites are to see if clinical trials are accurate. Go to the medication website itself. This is from it. I cut and pasted.
8 USE IN SPECIFIC POPULATIONS
8.1 Pregnancy
Teratogenic Effects: Pregnancy Category C. No evidence of teratogenicity was found in mice, rats, or rabbits when lamotrigine was orally administered to pregnant animals during the period of organogenesis at doses up to 1.2, 0.5, and 1.1 times, respectively, on a mg/m2 basis, the highest usual human maintenance dose (i.e., 500 mg/day). However, maternal toxicity and secondary fetal toxicity producing reduced fetal weight and/or delayed ossification were seen in mice and rats, but not in rabbits at these doses. Teratology studies were also conducted using bolus intravenous administration of the isethionate salt of lamotrigine in rats and rabbits. In rat dams administered an intravenous dose at 0.6 times the highest usual human maintenance dose, the incidence of intrauterine death without signs of teratogenicity was increased.
A behavioral teratology study was conducted in rats dosed during the period of organogenesis. At day 21 postpartum, offspring of dams receiving 5 mg/kg/day or higher displayed a significantly longer latent period for open field exploration and a lower frequency of rearing. In a swimming maze test performed on days 39 to 44 postpartum, time to completion was increased in offspring of dams receiving 25 mg/kg/day. These doses represent 0.1 and 0.5 times the clinical dose on a mg/m2 basis, respectively.
Lamotrigine did not affect fertility, teratogenesis, or postnatal development when rats were dosed prior to and during mating, and throughout gestation and lactation at doses equivalent to 0.4 times the highest usual human maintenance dose on a mg/m2 basis.
When pregnant rats were orally dosed at 0.1, 0.14, or 0.3 times the highest human maintenance dose (on a mg/m2 basis) during the latter part of gestation (days 15 to 20), maternal toxicity and fetal death were seen. In dams, food consumption and weight gain were reduced, and the gestation period was slightly prolonged (22.6 vs. 22.0 days in the control group). Stillborn pups were found in all 3 drug-treated groups with the highest number in the high-dose group. Postnatal death was also seen, but only in the 2 highest doses, and occurred between days 1 and 20. Some of these deaths appear to be drug-related and not secondary to the maternal toxicity. A no-observed-effect level (NOEL) could not be determined for this study.
Although lamotrigine was not found to be teratogenic in the above studies, lamotrigine decreases fetal folate concentrations in rats, an effect known to be associated with teratogenesis in animals and humans. There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
33
Non-Teratogenic Effects: As with other AEDs, physiological changes during pregnancy may affect lamotrigine concentrations and/or therapeutic effect. There have been reports of decreased lamotrigine concentrations during pregnancy and restoration of pre-partum concentrations after delivery. Dosage adjustments may be necessary to maintain clinical response.
Pregnancy Exposure Registry: To provide information regarding the effects of in utero exposure to LAMICTAL, physicians are advised to recommend that pregnant patients taking LAMICTAL enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. This can be done by calling the toll-free number 1-888-233-2334, and must be done by patients themselves. Information on the registry can also be found at the website http://www.aedpregnancyregistry.org/.
Physicians are also encouraged to register patients in the Lamotrigine Pregnancy Registry; enrollment in this registry must be done prior to any prenatal diagnostic tests and before fetal outcome is known. Physicians can obtain information by calling the Lamotrigine Pregnancy Registry at 1-800-336-2176 (toll-free).
8.2 Labor and Delivery
The effect of LAMICTAL on labor and delivery in humans is unknown.
8.3 Nursing Mothers
Preliminary data indicate that lamotrigine passes into human milk. Because the effects on the infant exposed to lamotrigine by this route are unknown, breastfeeding while taking LAMICTAL is not recommended.

[adel_ezz]

there is a site "www.clinicaltrials.gov" provided by ILADVOCATE and another one  "www.pubmed.com" i suppose, he said very reliable when it comes to checking the safety or validity of a certain drug

[paranoid_cataclysm]

Also I should point out you should still do some research and possibly try to find user reviews on the web for lamictal and see how many people had birth problems.  I think that's more valuable than any organization's information although the people who had negative experiences on these are sometimes biased and forget it might save someone else's life and not cause them problems at all.

[paranoid_cataclysm]

DOCTOROFMIND a psychiatrist on youtube said recently in a video there are a couple of safe psych meds for pregnancy, it wasn't one of them however and he only listed prozac and haldol although NAMI's website says prozac possibly causes serious birth problems and as for haldol it says you should tell your doctor if you're pregnant but says nothing about special precautions with pregnancy.  Hell he doesn't even like prescribing meds unless he absolutely has to.  Here's what I found on lamictal and pregnancy on NAMI's website:

Are There specific concerns  about Lamictal® and pregnancy?

Lamotrigine  can interfere with folic acid. Therefore, female patients should be aware that lamotrigine may increase the chances of birth defects in babies. New information suggests that babies exposed to lamotrigine during the first three months of pregnancy may have a higher chance of being born with a cleft lip or cleft palate. Babies born with cleft lip or cleft palate have a gap in the upper lip or roof of the mouth. More research is needed to be sure about this possibly increased chance of cleft lip or cleft palate in babies born to mothers who takelamotrigine.

I guess this all sort of shows contrast in how psychiatrists and NAMI can all have opposing views.

[adel_ezz]

hi Malak

for the pdoc it's better if you stabilize simply because the baby is of no concern to him, this is i'm afraid the responsibility of another person (your gaenacologist/obstetrician), so forget about what he's trying to convince you abt lamictal that it's is ok while you are pregnant, this is a research you have to do it yourself.

2nd, that you better be not depressed while pregnant, in this he is right, because one fears you may decide to get rid of the whlole issue (pregnancy) while in your lows, so it's in a way dangerous.

However, I suppose it's not so gloomy neither so bleak. My experience with the meds in general, whether xanax, lamictal (tried the infantile dosage only), you name it, is that you can't in general lower your dose suddenly or even smoothly, you will eventually have to increase it as you proceed, I compare this with trying to reach the land while swimming, you will meet the high tide then low one, then high etc... , in fact airoplanes do the same, they only keep landing - i.e. go down only - when very near the land, otherwise you find the pilot going down then a little up, etc...There is a comrade here (corryguy) who did the same while tapering off xanax, now i am giving him and you my explanation.

so in fact there are matters for you to investigate. 1st to be sure and hear from others abt the safety of lamictal, whether it is really ok or not, if yes, then you are lucky because you won't find better than lamictal to compensate for eveything. 2nd that your dose can be lessened,  indeed yes, but not monotonically rather with many ups and downs on your way down, so on the whole the resultant is down (of course your siblings, hubby whoever lives with you must know not to stress you by any mean, i.e. life should be enjoyable more or less or with no difficulties, i.e. not to worry abt cooking, etc...)  

to conclude, you shouldn't be very depressed while pregnant, but no harm done if you become lethargic because in fact pregnant women are weak and lazy by definition and not supposed to do an extra work except some walking necessary for the labor.

again, i wouldn't get frightened, neither panic, hold your nerves and move steadily and remember that we pray for you. Eventually, you will succeed, simply because many before you did it and you will do it. Then these days you will not remember, only look forward for the nice event to arrive, i am sure you will be a successful mother