I am 26 weeks pregnant. I have a 27 months old daughter. I developed a fever after I gave birth. I lost consciousness three days after the delivery. I then developed postpartum psychosis although I didn't have any mental disorder before and no family history of mental disorder. I saw a consultant last week. She said I was in high risk of developing postpartum psychosis and I'd have 2/3 chance of becoming ill again. She recommended me to take sertraline tablet now and start quetiapine at 32 weeks pregnant. I just wonder if any of you have the same or similar situation as me? Is there any of you have sertraline and quetiapine while on pregnancy?
Thanks
Isabel
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isabel12081
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I don't have any experience of second pregnancy sorry, but whenever I have talked about planning second pregnancy, my CPN and psychiatrist said that taking quetiapine in pregnancy is safe x
I was put on amitriptyline whilst pregnant with my second and third child. It is an older anti-depressant so they know it's safe in pregnancy. I was also able to breastfeed whilst taking it which was something that was important to me. Once you have suffered with puerperal psychosis you are said to have a very high chance of suffering with it again with further pregnancies. I never had a full blown psychosis again after my subsequent births but I did have down days. Also I had everything in place as a preventative measure. i.e. already on suitable meds, monitored very carefully by doctors and immense support from family and friends. Good luck. I really hope you aren't poorly this time and think you are ever so brave considering your physical illness after last time. x
Congratulations on your second pregnancy. Sorry to hear you had such a traumatic start to motherhood hood 2yrs ago.
I didn't take meds while pregnant but know that it is sometimes necessary and Drs will usually err on the side of caution.
However is there a reason the consultant suggests taking medication prior to birth. As in were you symptomatic before you gave birth or did it take you a while to adjust to the meds before they were effective.
During my second pregnancy I was given the option to take meds (quientipiene) from around 39wks or post natally. I chose to wait for symptoms before taking meds (which I did at day 7). However I knew that I reacted quickly to those particular meds and would probably have a slow building mania rather than jumping straight to psychosis.
Although trusting our health professionals is important it's also worth asking questions so that you feel comfortable with your decisions.
I'm currently pregnant with my second and was advised I only needed to start meds after delivery given I was well before hand last time and got sick a few days later (slow building mania but sudden psychosis). That said they're giving me very high dose lithium immediately after delivery (which isn't safe in pregnancy) and we have no idea how well it's going to work so fingers crossed?
I think the problem is we're all 'high risk' once we have a first episode, but since it's not 100% it's hard to tell which non-relapsers responded to the medications and which weren't going to get sick anyway, and it being a relatively rare illness so there's no absolute treatment consensus.
I agree with asking your doctor if you don't feel comfortable, or even a second specialist opinion.
I'm pregnant and my plan is to take Quetiapine after the birth as I responded well to that medication first time round. I never took an antidepressant. I've not had much of a discussion about it yet (early days for me) but I didn't get ill until 3 weeks after my son's birth so the nurse has said I could probably wait a week or 'watch and wait' as it's likely to follow a similar time pattern and the medication takes effect immediately.
I too had no previous history of mental illness and was told the risk of a further episode this time is around 50%.
I would agree with the comments above about discussing the need to start taking medication during pregnancy if it's not something you're comfortable with.
Hopefully you are aware that Prof Ian Jones offers a second opinion service through APP if that's something you'd value and something you're able to access - I saw him last summer and it was very worthwhile for me. app-network.org/what-is-pp/...
Have you also seen the APP guide for planning a pregnancy when at risk of PP? Lots of good information in there. app-network.org/what-is-pp/...
Hopefully you've got lots of support in place. There are various threads on here about care plans and experiences of second pregnancies, I hope you find it as helpful as I have.
Congratulations on your pregnancy and welcome to the forum. I don't have experience of meds in pregnancy but had a 2nd baby in 2013 after an episode of pp in 2009. Planning and preparation were really important for us and we wrote a care plan which included me taking a low dose of antipsychotic on delivery. We'll never really know as pp causes seem pretty complex and different for everyone but I stayed well 2nd time which was a great feeling after having been told I was 50/50 chance of being ill again, perhaps a bit more.
It's undoubtedly a scary time for you so all the support and input you can get will hopefully help you. We were really keen to minimize risk so made careful plans for few visitors after a longer stay in hospital for rest and monitoring after a planned c section. As I'd been discharged from mh services after my 1st episode and with no perinatal specialist services where I live, it was hard going at times as the awareness amongst professionals involved was pretty much non existent. Accessing the APP 2nd opinion service which JB55 mentions was absolutely invaluable and I can't recommend it enough. I felt listened to and understood and when Dr Ian Jones wrote to my midwives, hospital, go etc they finally sat up and listened which was wonderful.
It's good to hear that you have psychiatrist input and hopefully that is reassuring to you. Thinking about how you'd like things to be, what meds or treatment you'd accept (+ any you'd feel strongly against) then documenting it all can be helpful. I don't know if you accessed one before but I wanted to be in a mother and baby unit if I became ill so my eldest wouldn't see me at home. There's not any that close to me and with a lot of services linked to others further away I actually would have preferred an alternative which was about the same distance but more out of the locality yet nearer family members and my husband's work. Little details that will help you and you need others to know.
I hope others can help with the meds query part of your post but just wanted to write and wish you all the best, I hope you're finding info which is helpful to you. Xx
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