I was just wondering for those who opted for medication after pregnancy, what dose you went on please? Was it a very low dose? I was on Olanzapine previously and have only just come off this medication after three years and months of tapering before finally stopping. (I am so frightened about becoming unwell again but I've let everyone know to keep a super close eye on me during this time).
I understand you can go for the 'watch and wait' after birth and also go on medication towards the end of pregnancy and I'm happy and appreciative for you to share what you did and if the method you chose prevented you becoming unwell.
I would also love to know how long you stayed on medication after pregnancy before tapering and eventually stopping? I realise my staying on for three years is a long time and likely unnecessary but I had no support initially coming off and then when I did I was so afraid to come off but next time I would definitely like to come off sooner.
Thank you all 🧡
N x
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Rainbow9725
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I can share my personal experience with you. I took antipsychotic medication from week 36 of my pregnancy. My son was born at week 38 as I was induced due to my gestational diabetes.
I kept well during pregnancy and had routine checks with the perinatal team, I decided to take medication during pregnancy because I saw that in hindsight I was showing some signs of hypomania in the weeks towards the birth of my first baby. The dosis I started before birth was 2.5 mg of Olanzapine and then increased to 5 mg after birth. It allowed me to sleep for those first few months of the newborn stage which are so difficult for all parents. I was not in 5 mg for too long, 6 months, and then went down to 2.5 mg for about a month before dropping it off completely. Pp did not repeat for me though I did get some depression around month 2 or 3 postpartum that I was able to treat with medication and therapy and did not need admission.
I think the decision to take medication during pregnancy is very personal and dependant on your history. What I opted for suited me, but I know other mums who waited till the birth to start medication, it all depends on circumstances.
I am sorry you did not receive proper support to come off Olanzapine the first time and that can add to the worry around medication. My psychiatrist drew a weaning plan that was followed up by my GP when I was discharged from the perinatal team. And that was very helpful.
I wish you all the best in the near future and please do not hesitate to write here if there are any questions or anything you would like to share,
Thank you for taking the time to share your experience. I'm so glad to hear everything went well for you.
Were the gestational diabetes brought on by the Olanzapine or was that something you struggled with prior to going on medication? Was everything ok with you and Baby?
May I also ask how you find coming off Olanzapine? Did you suffer any withdrawals?
No, the gestational diabetes did not have to do with Olanzapine it was diagnosed before I started taking Olanzapine. I probably also had GD with my first baby but it was not diagnosed at the time, and it tends to repeat in pregnancies. My dad had diabetes and that is another risk factor.
I was able to come off the Olanzapine the second time around with more ease than when I weaned off it after my pp. I think part of it was that I was coming down from not such a high dose and partly that my brain was not recovering from pp this time.
My baby did fine after birth. We were in hospital for 72 hours to observe him and the paediatricians did not raised any concerns.
Take very good care and do let us know how you are getting on, it is great you are looking for more information before preparing for a second pregnancy. It is also a good idea to set a chat with a perinatal psychiatrist, a preconception counselling meeting. Your GP can make a referral to the local perinatal team and it is a good opportunity to understand what support will be available to you and ask any questions you may have.
So I am not pregnant yet but we plan to be this year. I’ve spoken to 2 psychiatrists and their plan is to have me go on Olanzapine 2.5 in week 34 of pregnancy. I will also be taking an antidepressant the entire pregnancy and a low dose mood stabilizer (Lamotrigine) (just in case even though I’m not diagnosed BD) the entire pregnancy. I had prenatal depression with my first so hence the antidepressant will be continued the entire time. Once I give birth they plan on putting me on Olanzapine 5mg. Both psychiatrists have said that will be enough. Even though I was on 15mg Olanzapine after my PP with my first child - the way it was explained to me - after you have PP you need a higher dose to get better. But as a preventative - 5mg is plenty enough. To keep well. They also said that I will likely only need to stay on 6 months. But I think I’d like to stay on for a full year. At least on 2.5mg.
Both psychiatrists seem to be of similar opinion. I feel like I’m in good hands.
Ps. I also had gestational diabetes with my first pregnancy so I’m assuming I’ll have it with my second so I’ll be on a strict diet. I’m trying to shed off the weight and eat better now so that I don’t gain even more weight before going Olanzapine again.
Thought I'd share as I am currently going through this with baby number 3. I chose to take Lithium after birth and I have a low dose of 2.5mg of Olanzapine in the cupboard as a just in case, and using zopliclone to manage my sleep while my husband is on paternity leave. I'm on day 6 at the minute and reached the crying stage but my CPN is happy this is hormones balancing. I also have friends on hand looking for signs of unusual behaviour. I understand how worrying it can be as I never have an insight into my own mental health. Having a new baby in the house is such a blessing I didn't want PP to hold me back. I think if you have the olanzapine there as a back up ready in the cupboard, it helps with the reassurance.
All the best, and I'm happy to chat if you need any more advice.
Thank you for sharing. Did you manage through pregnancy without any help?
Happy to hear you're doing well. I'd not thought of lithium but maybe that would be an idea. I've not heard of zopliclone so I'll do some research.
I'm glad the crying stage is deemed normal, I have heard from friends who have no mental health scares that they too reached that stage so hopefully that'll reassure you further.
I don't have experience of olanzapine as a preventative with a consequent pregnancy but I was just wondering if you'd share your experiences of PP first time round and what has brought you to the point of feeling comfortable to have another baby.
I had it 2023 and was sectioned from March - June without my boy he was 9 months when I was sectioned.
I really want him to have a sibling but I'm worried I wouldn't get the support from my family if I put them through it again.
Of course. I had PPP in December 2021, I became unwell around two weeks pp and I voluntarily put myself into a Mother and Baby unit with my Son around 3/4 weeks pp . I however didn't comprehend that was where I was going. I thought I was on my way to the police station and was in trouble but couldn't understand what for, it's just what my brain was telling me. I completely understand your fear of having another Child - my fear has heavily weighed on me all these years and the thought of going through that again scares me more than I can express. I think my want for a sibling for my Son is so great at this stage and that's my driving force. I also had an appointment with the perinatal team regarding another pregnancy and they put my mind at ease that they would be there throughout. I also have support from family although they're not entirely on board with the idea of having another Baby, I know they'd support our decision if we were to go ahead.
So sorry to hear you were sectioned, that must have been so scary and traumatic for you especially being without your Son. Were you able to see your Boy in that time? Were you unwell prior to being sectioned at 9mths pp?
This illness honestly weighs heavily on you and I feel unless you've been through it you cannot understand how much it effects a person not just at the time but for many years to follow.
Bless you I'm so sorry to hear. I'm glad you're at the stage where you know your family would support you with your decision.
Yea it was traumatising to say the least. I was fine up until about 5 months PP when I stopped breast feeding, I had severe pp depression and anxiety. Started on sertraline in around November but then got psychosis early March so I was unwell for a long time but not mania like it became. My dad took me to A&E on 3 seperate occasions before they sectioned me too and they told me I was exhausted and to go home and have a hot bath and cup of tea 👀🤦🏼♀️. I saw him around 6 weeks in so I didn't see him for 6 weeks but I can't really remember much from those first 6 weeks in the ward it's all very chaotic and blurred.
I'd really like another and Im glad there's pre natal support xx
I took Quetiapine after my second pregnancy rather than Olanzapine, but thought I'd add my experience just in case any of it is helpful to you (while being mindful that everyone and each case is individual).
When I had PP (back in 2012) I was on 300mg Quetiapine (modified release) for 12 months before tapering off it over 3 months. When I was pregnant with my second there wasn't a perinatal mental health team in my area and I had outreach support from the team attached to the MBU where I'd been a patient. It wasn't felt that I needed to go on medication during pregnancy as my PP hadn't started immediately after the birth (it was around 3 weeks postpartum) and I decided I didn't want to take a 'watch and wait' approach as I thought it would make me too anxious, so I opted to go on medication after delivery. They recommended I go back onto 300mg after the birth which I didn't want to do. I managed to have a consultation with Prof Ian Jones (who I'd had a consultation with ahead of getting pregnant again, through his second opinion service) late in my pregnancy - I wanted to go on a lower dose and then up the dose if needed, which he'd talked about in our original consultation. He supported this plan in my case and wrote to my GP so she was able to prescribe the meds. So I went on half the dose - 150mg - which I started when I came home from hospital, with the plan being that if I started showing any early signs or symptoms of PP, the dose could be upped quickly. I fortunately stayed well, and I stayed on this dose for 6 months before tapering off under the supervision of my GP (lowering the dose by 50mg at a time, staying on that dose for a couple of weeks, checking in with her over email that I was doing ok, then lowering it again before stopping it).
As I said, there was no perinatal team here at the time and I was under the care of my GP. If I'd become unwell, I would have been referred into mental health services at that point. I felt very well supported but I'm sure there is more specialist perinatal MH support and supervision now. I think it is important to discuss all the options with the team supporting you, and agree a plan that you're comfortable with. I hope hearing other's experiences is helpful - I know I wanted to feel as informed as I could too and it was reassuring to read what others had done.
Do feel free to ask any questions, and do get in touch if you'd like to have a chat at any point.
I’ve recently had my second baby after PP with my first baby. Similarly I was on my antipsychotic Quetiapine for over 3 years at 800 mg before coming off it, and then fell pregnant very soon afterwards. I was using it as a crutch I think and could have come off it sooner but again was scared.
I chose to take medication straight after birth . I could have done the watch and wait but for me I think I would overthink everything and look for signs of PP that weren’t there.
I quickly went up to taking 200mg in 50mg intervals over 6 or 7 days. It really helped with my sleep and I had a lot of support from my partner to make sure I prioritised sleep, and it helped me to relax and minimise my fear of PP returning knowing I was taking preventative medication. During the time of increasing I did experience some minimal side effects that I’d totally forgot happened first time round which was a bit alarming but it went away quickly and was reassured/ and monitored by perinatal during this time. Perinatal/midwife or health visitor monitored me through daily visits for the first 10 days after birth too which was reassuring.
My little boy is now 9 weeks old and I’ve had no warning signs of PP returning this time round and have had regular support from Perinatal services. It’s been such a nice experience this time round. Like you I want to come off it sooner and have a plan to start reducing my medication once my little boy is 12 weeks.
I was frightened too, but having survived Pp first time round and knowing what to look out for made me comfortable that I would be able to get through it should it happen again. It was a risk but knew I would have a lot more support this time round from family friends and services and I wouldn’t be giving birth in Covid like last time.
Good luck with everything and if you have any more questions feel free to contact me.
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he was 9 months when I was sectioned. 
Losing weight after Olanzapine 
2nd pregnancy 5 years later after having PP
PP Veteran
