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Bipolar Disorder in Pregnancy

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Bipolar Medications During Pregnancy continued...

To reduce its risks to you and your child:

  • Drink plenty of water to prevent lithium toxicity.
  • Have lithium levels checked often -- in you and your child -- especially if you are breastfeeding.

Both valproate (Depakote) and carbamazepine (Tegretol) may lead to birth defects such as neural tube defects. And most experts say it is a good idea to stop them during pregnancy. You may need to switch to another drug.

There is less information on the safety of newer anticonvulsants. However, lamotrigine (Lamictal) may be a useful alternative for some women.

Antipsychotic medications. Antipsychotic medications can be used during acute treatment of mania, especially to manage delusions or hallucinations. Examples of newer antipsychotics include:

Your doctor may suggest that you switch during pregnancy to an older-generation antipsychotic such as haloperidol (Haldol). This may also be a good idea if you've stopped taking a mood stabilizer but symptoms came back.

Antidepressants. There is less information about the effects of antidepressants on bipolar disorder and pregnancy. If you are on antidepressants, your doctors will watch you closely for mood switches or the acceleration of cycling. Also, know that these drugs may increase the risk of mania. This is especially true if mood stabilizers have been stopped.

Electroconvulsive Therapy (ECT) During Pregnancy

Also known as electroshock, this therapy can have a therapeutic effect for mood disorders. During pregnancy, this type of therapy causes few complications. But to reduce the risks, your doctor may:

  • Have the baby's heart rate and oxygen levels monitored during ECT.
  • Suggest antacids or placement of an airway tube (intubation) to reduce the risk of gastric regurgitation or lung inflammation during ECT.
  • Encourage you to eat well and drink plenty of water to help prevent premature contractions.

 

Other Steps You Can Take

Do what you can to exercise and manage stress. And maintain structure in your day. These steps can help you get good sleep and reduce rapid shifts in moods. As always, psychotherapy can also be a big help.

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WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on February 01, 2013
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