Medication and second pregnancy - Action on Postpar...

Action on Postpartum Psychosis

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Medication and second pregnancy

Orea profile image

Hi, I was hoping to get some advice from women who have had PPP and gone on to have a second pregnancy. I had severe PPP with my first born, developing only a couple of days after birth. I was admitted into an MBU for 3 months. Responded quickly to treatment on Olanzapine. Several tumultuous years followed of periods of depression, and some manic periods requiring re-admission. Ultimately, I think I developed bipolar off the back of my initial PPP (with a strong family history of bipolar, even though I never suffered from it before).

I have put off having a second child for 6 years now, as I just can't deal with the anxiety and not knowing what to do for the best. Medicate through a second pregnancy or not. All the advice seems really conflicting and uncertain. I am currently on 225mg Lamotrigine and 5mg Olanzapine, and imagine I probably will be for life. But I am considering coming off everything for a second pregnancy, as no one seems to be able to reassure me about potential side affects to the fetus during pregnancy. Does anyone have any further experience of this?

6 Replies
EmiMum profile image
EmiMumVolunteer

Hi Orea,

Thank you for reaching out to the forum and also sharing your story. I am sorry to hear you had pp after the birth of your baby 6 months ago and had further depressive and manic episodes.

With pregnancy and medication there is always a balance between the risk and the benefit, which is a very individual thing, isn't it? But it makes it quite hard sometimes.

When I was planning my second pregnancy, having had pp in 2018, I checked this website which has very clear information about medication during pregnancy, search for the relevant medicine in the leaflets section and it will open a page with up to date information about potential risks: medicinesinpregnancy.org/

I wonder if where you live you can be offered a preconception counselling chat with a perinatal psychiatrist, that is another good source of information. I attended one in April last year and medication was one of my main questions.

I am sorry you are feeling that the information so far seems conflicting. I am aware it is difficult to gather good experimental data for medications during pregnancy due to ethical issues.

Are you currently followed up by a psychiatrist? It's important regardless what you decide at the end to draw a good plan regarding medication in conjuction with your doctor, so they can make sure you are keeping well while you are trying for a baby and during your pregnancy.

Take good care Orea, hope this helps a bit and all the best in the near future

EmiMum profile image
EmiMumVolunteer in reply to EmiMum

I am sorry I meant to say after your baby 6 years ago. I am sorry mental cobwebs in the morning. Take care

Hi Orea,

I too had severe PPP so totaly understand your very real fears.

I went on to have a second child with no medication and suffered no PPP.

I was closely monitored throughout my pregnancy and post birth.

Be strong, you've got this.

Sarah

Lilybeth profile image
LilybethVolunteer

Hello Orea

Welcome to the forum and thank you for sharing your experience of PP. I can understand your hesitancy about a second child after suffering such a traumatic illness. I had PP many years ago before MBUs, was sectioned to mixed general psychiatric care, without my son, and spent six months there. It took me a long time to recover and then I was hit with depression.

Like you, we wondered about a second child and six years later our second son was born. We were so delighted but at home (according to my notes) my husband recognised similarities of my first PP. So professionals were alerted and I was again sectioned and under mixed general psychiatric care. There is a section in my notes from the psychiatrist recording that for some reason I had slipped under the radar and should have been medicated.

I’m sorry to hear you developed bipolar ... there are mothers of courage, like you, here who face this challenge. There are resources which might be helpful, for example, on the PP Insider Guides page at app-network.org/what-is-pp/... there are personal stories. One of which is an article from Bipolar Pendulum Magazine entitled “PP and how I avoided it second time round”.

There is a lot to weigh up and it’s not an easy decision, taking into account also how your partner will be supported. Wishing you well for the future. Take care.

Ellie_at_APP profile image
Ellie_at_APPAdministrator

Hi Orea,

It's great you've found us, and written this post on the forum to hear experiences of others who have planned a pregnancy and been at risk of becoming unwell.

I had PP in 2011, and really struggled with depression afterwards as well, so had quite a long recovery. I'm sorry to hear about your experience of struggling with periods of depression and mania afterwards, and that you now have a bipolar diagnosis. It sounds like you have had some really difficult times.

I personally didn't decide to have anymore children, but I can completely relate to the conflicting feelings, worries and questions. I couldn't even consider it until my son was 5 - so I can completely understand that you haven't felt able to think about it until now.

I wanted to write and let you know that there's a lot of information and links around planning a pregnancy if you have a Bipolar diagnosis, on our website here, if you haven't found it already:

app-network.org/what-is-pp/...

If you are in the UK, I would really recommend that you request a pre-conception meeting with a perinatal psychiatrist. In England, and I think in Scotland and Wales now too, there are now specialist perinatal mental health teams, who can advise you about a second pregnancy, and also support you through the pregnancy and post birth, if you are at risk of severe mental ill health.

You are right, that there isn't much evidence about the impact of different mental health medications on the baby if they're taken during pregnancy; from what I understand, for most medications, there is also not much evidence of harm either. A specialist perinatal psychiatrist would be able to give you this specialist information about the medications, and explain your different options. You can ask your GP to refer you to the team.

I do hope this is helpful, and I hope that some others who have a bipolar diagnosis and have planned a pregnancy will be able to share their experiences with you as well.

Take care,

Ellie

Frankieb profile image
FrankiebVolunteer

Hi OreaI have had a second child after PP, unfortunately I did go.on to experience it again, but, and it's a big but, things have really moved on. Theres so much more understanding and support available now.

You GP should be able to refer you to a specialist Perinatal mental health team, they will be able to advise you on medication and so on.

I work in one of these teams and we take similar referrals every week.

Please get specialist advice, replies on this forum are wonderful but specialist advice based on your circumstances and previous experiences are vital.

Good luck with everything

Barbara x

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