Today is a Q and A session on Lithium and pregnancy
It’s a question from a young lady, medicine based advice, so naturally I steer away quite a bit from that, rather I discuss it more and then advise that the person talk with a Psych
“I have a long history of Bipolar I, but lithium calms me down and keeps me focused. I am now pregnant with my super husband and have a question”
Should I stay on the Lithium?
I have had a long discussion with my Consultant psychiatrist, we don’t really get on though. I have doubts though after reading about mums on Lithium online. I don’t know what to do. I don’t want to make the “wrong” decision.
I thought about answering this question, as I said before-I can’t and won’t give medical advice, as while I’m probably more qualified than 90% online, I am not a Medical Doctor or a Psychatrist.
I would always say run with your psychiatrist’s advise. Lithium is the gold standard treatment for treating bipolar and the most popular treatment of Bipolar in pregnancy.
Lets talk risks
The biggest risk (which isn’t very big) is the heart defect. It’s all risk vs benefit, the risk for the mother of relapse from Bipolar during pregnancy is 80%. There is also the higher risk of post natal depression (PND) and post partum psychosis (PPP),so it’s beneficial to be on treatment post partum . Its beneficial to be on Lithium, period.
Taking Lithium does mean that you should not breastfeed your baby, as Lithium is present in breast milk and you’d require blood tests for the baby and it’s not entirely desirable.
Some say there isn’t a right or wrong answer, it’s dependant on Bipolar severity and what is appropriate for you. The risks are different to the next lady and anyone else’s. At the end of the day it’s all risk vs benefit. There is no shame in being on medication while pregnant, so you can be a well and happy mother to your child.
Ultimately, I would suggest seeking out a perinatal psychiatrist. These are absolute experts.You may be on other meds and there may be biological or mum or baby issues as the pregnancy progresses.
From the research I’ve done, there is only a small risk of heart defects if you take lithium throughout your pregnancy, about 1 in 1000. If you take lithium only after the first trimester, there is almost nil risk for heart defects, but don’t stop and start the lithium, rather- read on !!
Treating bipolar disorder during pregnancy reduces the risk of postpartum episode. Lithium has also been shown to be a very effective preventative medication for post partum psychosis, which bipolar women are at greater risk for.
All roads lead to a “Yes decision”, but get a Perinatal Pysch and good luck
Quick note: if you are on Lithium or medication, do what all sane people do, don’t read online forums on Mental Health matters!!