Question about preventative medicine

[Wiwa21]

Hello lovely PP community,

I hope most of you are well.

I am 16 weeks pregnant and doing well, feeling excited, supported and also actually quite hopeful that my second pregnancy and postpartum period will be all right. My husband and I, with great support of professionals are working on a preventative care plan and a care plan should I unfortunately become unwell again.

One of the things I still need to decide on is whether and when I will take prohylactic anti-psychotics or not, and the same goes for sleep medication, or perhaps even both. There is quite some info out there on using anti-soychotics in a preventative way but I have heard /seen less about using sleep medication.

Anyone any experience with this? Experiences on any kind of preventative medication are welcome any, also anti-psychotics trying to make an informed decision although of course every person is different and ultimately I can only do what feels best for me and my family - hoping for the best...

Thanks a lot!

[Maria_at_APP Moderator]

Hi Wiwa21, congratulations! I am so glad you are feeling well supported and hopeful in this pregnancy, a good team with good communication makes the world of difference.

With my second pregnancy I took anti psychotic medication preventative, maybe from week 34 or so, if memory serves. It was olanzapine in my case and it has a strong sedative effect for me, which is very common, so it helped very much with sleep and rest towards the end.

I checked the bumps website and searched for sleep medication, and there is some information in there that could be useful for you:

medicinesinpregnancy.org/

It is good you are discussing all options early on with your team. As your pregnancy progresses and according to how you are feeling things can be tweaked, added or removed to help you.

Take really good care, let us know how you are getting on, wishing you all the best in the near future

[Wiwa21 in reply to Maria_at_APP]

Thanks Maria, I will have a look at that website. Very helpful!

[Maria_at_APP Moderator in reply to Wiwa21]

Yes, I went in there a few times, very good quality of information. Take care

[Zebunisa_at_APP Moderator]

Congratulations Wiwa21 again from me

I’m glad to hear everything’s going smoothly. I too would be hesitant to take medication whilst pregnant but would look at the pros and cons and probably decide on something not so strong for medication wise. I know that regardless of what you choose you will have plenty of support this time round.

I think the best thing you can do is be prepared and keep calm. Hopefully everything will go well and feel free to write on here we are here to mention some of our experiences too which you may find helpful too 🥰

[Wiwa21 in reply to Zebunisa_at_APP]

Hi Zebunisa, thanks a lot again Yes indeed I am also not overly keen to take anything during pregnancy for health reasons of baby. So definitely erring on the side of caution there. Also my psychiatrist said there doesn’t seem to be an indication I need that as I was really well during pregnancy last time and only got unwell later. Only thing I may use is a very low dose sleep medication, should I have trouble sleeping. We were exploring Promethazine which is actually not even sleep meds it is an antihistamine with the side effect of making you drowsy and generally seem OK in pregnancy. But yeah if possible nothing and only after deliver or wait and see like Rkmummy listed below.

I just find a lot of info on anti-psychotics and mood stabilizers but less on sleep medication in itself.

All the best,

Willemijn

[Zebunisa_at_APP Moderator in reply to Wiwa21]

I would say look in to the medications being suggested and then make a decision from there.

Personally I would probably agree to a small dose of Medication post birth but then might not be able to breastfeed.

I’m sure regardless you will have a good perinatal team supporting you 💕

[Wiwa21 in reply to Zebunisa_at_APP]

I certainly do, actually leaning toward taking something preventative straight after birth! And I am actually fairly lucky that the antipsychotics that seemed to work last time (Haloperidol) did allow for me to continue breastfeeding, albeit combi feeding. So that gives options, at least it doesn’t fully rule it out. I will consult with my psychiatrist. Thanks!

[Zebunisa_at_APP Moderator in reply to Wiwa21]

Good idea! Here if u need anything

[RachelK_at_APP Moderator]

hi wiwa21

Hope you are doing well in your pregnancy

I was given three options for medication

1. Take it at the end of pregnancy

2. Take it after I give birth

3. Dont take any and see what happens.

I ended up choosing option 2, took for 11 weeks then stopped.

Take care

Rk

[Wiwa21 in reply to RachelK_at_APP]

hi RK, thanks! Yes this are indeed the options and I am in doubt between 2 and 3. As mentioned in my reply to Zebunisa I would only consider something very light during pregnancy but prefer to stay away from heavy mood stabilizers if possible. Good to know you did it for 11 weeks, that was indeed still one of my questions I wanted to ask medical specialists. If you take it as a preventative medicine and you do stay well, then when is the moment you start reducing/stop using it.

Thanks a lot, have a nice weekend!

[RachelK_at_APP Moderator in reply to Wiwa21]

When I had my meeting I went with a list of questions. So your doing well in seeking advice on here and being prepared for your meeting.

As I was on olanzapine and it has a sedative too I found it very difficult for night feeds - I used to take it just before bed, my husband would do any wake ups before 1am but after that I could manage to get up. It also gave me a ‘hangover’ affect where I would feel groggy in the mornings. So after a couple of weeks and no sign of me becoming unwell, (with advice from my doctor) I reduced the dosage and made a plan to stop taking it - which took me to 11 weeks after giving birth.

Good luck got your appointment

Rk

[Wiwa21 in reply to RachelK_at_APP]

very helpful! I recall that feeling of “hungover/groggy” in the morning. Not nice…

[Arabella-]

Hi there,

I used Olanzapine as a preventative (anti-psychotic) and it worked well. No PP for my second or third pregnancies.

Congratulations on your exciting news! Xx

[Wiwa21 in reply to Arabella-]

Thanks for sharing Arabella!

[NicJK in reply to Arabella-]

Hi Arabella, have you decided to stay on Olanzapine permanently? I have been on it for 3 years now

[Arabella- in reply to NicJK]

Yes hun. I’m currently on 7.5mg but aim to drop it to 5mg next year.

I can’t risk losing my s@@t when I have children to care for. I think, if I have diabetes and took insulin, no one would bat an eyelid. So why judge myself for taking psychiatric medication?

Have a great weekend x

[NicJK in reply to Arabella-]

Hi Arabella- sorry for my late reply. I think your diabetes analogy is such a good one- you’re right. I gave birth to my second child last week and Olanzapine has really helped me to stay stable. I hope that you feel better on 5mg - that’s the dose I’m on. The one thing I’m concerned with in terms of staying on the med permanently is tardive dyskinesia which is a movement disorder that comes on after you’ve been on the drug for many years. Have you spoken to your doctor about this? Interested to hear what other docs have to say about it. Hope you’re well xx

[Arabella- in reply to NicJK]

Gosh. I haven’t heard of that. I’ll speak to my psychiatrist about it, thanks for telling me.

Congratulations on your new baby!! How are you? How is baby?

Sending love and hugs 🤗 xx

[Jocelyn_at_APP Partner APP in reply to Arabella-]

Hi Both,

I hope you are both well!

I've not heard of this before either and have no experience or knowledge of it but did have a quick look...

Mind has some useful information about it here - mind.org.uk/information-sup... -

which might be worth looking in to. As always, we'd always recommend speaking to your health professionals about any questions or concerns.

Take care,

Jocelyn

[Arabella- in reply to Jocelyn_at_APP]

Thank you 🙏 so kind of you. My next check up is in October I’ll ask then x

[Arabella-]

you’re welcome darling! Have a great weekend xxx