Q:  Geodon, Lamictal, Zoloft & Pregnancy

Hello there.

My wife is taking Geodon, 40mg morning and evening, Lamictal 200 mg and Zoloft 100mg.   Are there any hazards to her or an unborn child while taking these medications??

Thank you.
 

Dear Mitchell -- 
I presume her doctor knows she's pregnant?  That's the first thing to make sure of.  None of these medications is known to cause trouble, as is the case for medications like Depakote and lithium.  The problem is that it's a lot easier to know that a medication does cause a problem than to know that a medication does not cause abnormalities in a developing, as-yet-unborn, child.  (or a developing, already-born, breast-feeding, child -- another issue). \

So, none of the medications on her list are known to be safe.  See the difference?  No one can assure you or her that these medications are not a hazard to your developing child.  However, there is good evidence that having mental health symptoms, at least if they are severe, is a hazard to that child. So whatever you do, don't read this and tell her to stop taking those medications. 

Woman who become pregnant, or who even might become pregnant, while taking medications for bipolar disorder, must be working closely with their doctor regarding how their bipolar disorder can be managed during a pregnancy.  That's a very individual decision, and generally a very tricky one, because there are no "mood stabilizers" that are clearly safe in the first trimester of pregnancy.  Some may be safe in the second trimester and thereafter, so the game plan shifts from before-pregnant, to getting-pregnant, to 2nd-trimester, and especially around childbirth because the likelihood of bipolar symptoms right after birth ("post-partum") is very high without medication protection, yet breastfeeding is often a goal as well.  

Ask her if her doctor knows; then ask if it's all right for you to talk with the doctor about your concerns.  Just be careful with how you talk with the doc', okay? 

Dr. Phelps

Published May, 2004