Lithium Discontinuation While Attempting to Conceive
For women with bipolar disorder who are planning a pregnancy, it is common practice to discontinue mood stabilizers prior to attempts to conceive, since the mood stabilizers most commonly used to treat bipolar disorder (lithium, valproic acid, and carbamazepine) all carry some risk of birth defect. The problem with this approach is that, after discontinuation of maintenance treatment, a woman is at very high risk for relapse. The longer it takes to get pregnant and the longer she remains off medication, the greater is her risk for having recurrent illness.
Breastfeeding and Antidepressants
When discussing the use of antidepressant medications by breastfeeding women, It is somewhat misleading to say that certain medications are “safer” than others. All medications taken by the mother are secreted into the breast milk. The amount of drug to which the infant is exposed depends on many factors, including the medication dosage, as well as the infant’s age and feeding schedule. To date, we have not found that certain medications are found at lower levels in the breast milk and may therefore pose less of a risk to the nursing infant. Nor have we found that any antidepressant medication has been associated with serious adverse events in the baby.
Benzodiazepines and Pregnancy
The following post was written in 2001. The inforamiton has not changed considerably, but here are some more recent articles on this topic:
Selecting an Antidepressant During Pregnancy
Most women and their doctors try to avoid using medications during pregnancy. Of greatest concern is that a medication used during pregnancy may in some way harm the developing fetus or, at the very worst, cause a birth defect. But what happens when a pregnant woman needs to take a medication?
Alternative Treatments for PMS
During the two weeks prior to the onset of a menstrual period, many women experience physical symptoms, such as bloating, breast tenderness, headache, and muscle aches. A small proportion of women also note a change in their mood and complain of irritability, mood swings, depressed mood, or feeling tense. If these symptoms interfere with a woman's ability to function, she may have premenstrual dysphoric disorder (PMDD).
Bipolar Disorder and Pregnancy
Unfortunately the mood stabilizers most commonly used to treat bipolar disorder (including lithium and valproic acid) can increase the risk of certain types of birth defects or congenital malformations in children exposed to these medications during the first trimester of pregnancy. For this reason, many women with bipolar disorder choose to discontinue maintenance treatment during pregnancy. However, we have observed very high rates of illness during pregnancy among these women who discontinue treatment; over half of the women relapse, most frequently during the first trimester.