Saturday, June 16, 2007

Article: When Conception is the Question

In the Spring 2007 issue bp Magazine had an article about the decision to have children when you are bipolar. I found it really sad the number of people who think that because they are bipolar -- they couldn't have children. I feel like there is a ton of misinformation about the chances of passing on the disease and how you can keep yourself well during pregnancy.

They now have the article online at:

Friday, June 15, 2007

Close Monitoring of Pregnant Women with Bipolar Disorder Improves Outcomes

Interesting article from Medscape Today:

Close Monitoring of Pregnant Women with Bipolar Disorder Improves Outcomes
May 29, 2007 (San Diego) — Careful follow-up of pregnant women with bipolar disorder (BPD), with close monitoring of their medication and compliance with outpatient psychiatric care, results in obstetrical outcomes similar to both women with major depressive disorder (MDD) and national population statistics, according to a study presented at the American Psychiatric Association 2007 Annual Meeting.

"The outcomes of the bipolar women who were treated carefully were the same as, if not better than, the women with major depression," said lead author Yara Betancourt, a graduate student in the department of psychiatry at Emory University in Atlanta, Georgia. "The national population statistics are not controlled for mental illness. Our study suggests that we can [at least] mimic national statistics by careful monitoring."

Pregnancy Outcomes

Although there is a burgeoning literature on the effects of maternal depression and anxiety on perinatal outcomes, "very limited research" addresses the issue of adequate treatment for BPD during pregnancy and the effects that it can have on outcomes for mother and newborn at the time of delivery, the authors write.

Read full article

Why I decided to Stop my Bipolar Meds for the FIrst Trimester

I've discovered that planning for a pregnancy can be difficult for anyone, but being bipolar and on medication presents an extra level of challenges. Since 2003, when I had a severe manic episode, I've been stable. In part because I was on medication. In part because I learned to take care of myself.

Years ago I asked my psychiatrist about having kids, and he suggested I should adopt. Now he is working with me on a plan to go off Lamictal for the first trimester. It's a little scary to think that I will be medication free for months -- it is a risk. I hope I am prepared for the challenge.

Some people in my life have questioned my decision to stop medication for part of the pregnancy and then go back on. I realize that it is a chance some people aren't willing to take -- and there is little concrete data to really guide someone.

So why did I decide to quit meds? Lamictal is a Class C drug during Pregnancy. This really means they don't know if it is safe or not. Of the various pregnancy registries that tracks Lamictal exposure only one has shown an increase in birth defects -- particularly Cleft palate. Exposure to that type of birth defect is only in the first trimesester. Some researchers actually think it is not true due to the sample size. Statisically the latest report from the lamictal registry shown the risk of birth defects at 3% -- the baseline risk across the board is 3% - so it is entirely possible that it is completely safe. However I wanted to minimize the small risk anyway.

Click here to learn more about Lamictal and cleft palate