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Thursday, August 6, 2020

Bipolar disorder medicine during pregnancy.

Bipolar disorder medicine during pregnancy. 


Bipolar disorder ( manic depression ) refers to experience of extremes of mood swings from high energy levels / manic euphoria to depressive levels usually with cycles over many days, weeks or months . Some famous actors and celebrities like Carrie Fisher (who is famous for her character of Princess Leia in Star wars ) have been very open about their battle with bipolar disorder. Carrie Fisher has publicly disclosed her diagnosis with bipolar disorder and given many interviews about her experience with bipolar disorder. Drinking alcohol is also likely to negatively affect the mood swings of people having bipolar disorder.

People with bipolar disorder are usually prescribed a combination of different drugs called a drug cocktail of mood stabilizers, anti depressants, anti psychotic ,anti convulsant drugs  and(examples are lithium, valproic acid, lamotrigine, carbamazepine , ariprazole , clozapine, lamotragine etc ). Many people wonder if bipolar women on medication can give birth to healthy children. There are many examples over the years of bipolar women on medication giving birth to healthy children. Bipolar disorder in pregnant woman usually needs a lot of attention from properly trained doctors. But some of the good psychiatrists may charge expensive fees and may be out of reach of most pregnant women who may have to consult their insurance companies also .  Insurance companies sometimes decline them or charge exorbitant amounts for people with bipolar disorder.

One of the main concerns for pregnant women is if the medications for bipolar disorder can be continued during pregnancy. The doctors you consult will usually show you which medications are usually harmful and which are not usually harmul during pregnancy in various medical studies. There may be a lot of trial and error testing with different combinations, before settling on a good combination of drugs to use during pregnancy. So it is better to get the consultation with the doctor and get a stable combination going before trying to conceive ( ttc ). But that is not always possible because of unplanned  pregnancies .  ( Bipolar  disorder may also be associated with irregular menstrual cycles and some other menstrual abnormalities. Some of the medicines for bipolar disorder may cause menstrual irregularities.

 Some of the common medications for bipolar disorder may increase the risk of birth disorders and some other birth anomalies like Ebstein’s anomaly ( especially during the first trimester ). Some studies show that medications involving  Lithium may be associated with defects of the baby's heart, while some doctors would like the mother to be hydrated so as to control lithium toxicity. Doctors who prescribe lamotrigine (an anti convulsant or anti epileptic drug ) may ask the women to take higher dosage of folic acid supplement than usual. 

Some of the women who stop their medication without consulting the doctor during pregnancy may suffer relapse like being unable to sleep, experience anxiety, depression etc . Pregnant women and their partners are usually concerned about what mood stabilizers are safe during pregnancy. Breast feeding after pregnancy is also challenging for women with bipolar disorder on medication. Some of the medications used for bipolar disorders will also be present in traces in the breast milk for the baby .  Even after the breast feeding stage, the weaning stage might also present some hormonal changes in the levels of oxytocin and prolactin in the mother which might be a trigger for emotional swings / changes for the mother


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