Hello

I am 26 years old and was diagnosed with rapid cycling bipolar disorder about a year ago. After a bit of trial and error I was able to recover from a major manic psychotic episode and nemerous suicide attempts. I was taking the drugs Epilum and Avanza.

My husband and I wish to concieve in the near future and I have gone off my medication to do this. I am currently experiencing a severe depression that is just not passing. My question is are there any medications that i can take whilst trying to concieve and whilst pregnant? I feel like I will have to choose between a child and my sanity.

Many Thanks


Dear Ms. M' -- 
There are several relatively safe ways to do this but you need to work closely with a psychiatrist who knows what she/he is doing.  This is a very crucial and complex step you're about to take and you should definitely have a clear strategy in mind before you conceive.  If your doc' is not comfortable giving you guidance, you could get a consultation from another psychiatrist more expert in this (I deal a lot with bipolar disorder, but for patients of mind considering pregnancy I might well send them off to Portland, a 2 hour drive, for additional input -- there are several ways to proceed, all with differing levels of risk to you and to your child, so you really want some help thinking this through with someone whom you feel really knows what they're talking about).  Since you're now off medications, it would be nice to get your information on options as soon as possible, obviously; but if there's going to be any significant delay, like more than a few weeks, you should be back in touch with your previous doc' to let her/him know what you're doing here (that is probably a good idea no matter how long it might take to arrange for more input), that you're not currently on medications, and that you're having depression symptoms again. 

You definitely don't have to choose between a child and sanity, but you have to make some careful choices about risks; even the step you're taking now has some risk to it, as you're probably well aware.  Move quickly now, and good luck with that. 

Dr. Phelps