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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Angielala on February 1, 2005, at 11:34:06
Hello there,
Here's my issue. I'm 4 weeks pregnant and I'm on Lamictal. I came out of a pretty harsh mania about a month ago, and think coming off Lamictal would be a bad idea. My problem, I have yet to find a doctor to give me advice- my psychiatrist and primary care doc both say that they do not know enough to give me any advice as far as taking Lamictal during pregnancy. There are specialists, but none are covered by health insurance and there aren't any around Rhode Island. I'm pretty much stuck without any help.
The internet research I have done all say the same things- there isn't enough human research and they can't say whether or not it's better to stay on or get off of it during pregnancy.
I hate feeling alone and scared about this, and can only imagine how many others feel the same.
Is there any where you can point me?
Thank you,
Angielala
Posted by SLS on February 1, 2005, at 14:09:14
In reply to I take Lamictal and I'm Pregnant, posted by Angielala on February 1, 2005, at 11:34:06
Hi.
I can't begin to imagine how wrenching must be the experience of wanting such information and not getting it.
> Here's my issue. I'm 4 weeks pregnant and I'm on Lamictal.If your manias are so disruptive, and you are confident that Lamictal is preventing it, I would see continuing on Lamictal to be one of your better choices. The anticonvulsant most associated with birth defects is Depakote (valproate; valproic acid). So far, Lamictal seems to be OK, but there is insufficient study of this issue to be able to absolutely guarantee its safety. I'm sure that is a frustrating answer to keep hearing. Right now, there are several pregnancy registries being organized to record pregnancy outcomes while being treated with these medications.
"Each has enlisted 3-5,000 pregnancies in women with epilepsy, and the North American and the U.K. have released preliminary observations. Thus the U.K. registry reported a higher malformation rate with valproate, 5.9% (4.3-8.2%; 95% CI), than with carbamazepine, 2.3% (1.4-3.7%), and lamotrigine, 2.1% (1.0-4.0%). Most of the more recent cohort studies have also identified a nonsignificant trend toward a higher teratogenicity with valproate."
From:
Epilepsia. 2004 Oct;45(10):1171-5.
Navigating toward fetal and maternal health: the challenge of treating epilepsy in pregnancy.Tomson T, Perucca E, Battino D.
Posted by banga on February 1, 2005, at 14:11:08
In reply to I take Lamictal and I'm Pregnant, posted by Angielala on February 1, 2005, at 11:34:06
Did your search for information include the Harvard Women's Mental Health info on the web? YOu probably did, but just checking because they have a whole research division that looks at medication and pregnancy. Maybe if you tried to work through the names mentioned there, they could give you advice as to who you could go to? Maybe someone even is covered by your insurance, who knows.....
Posted by SLS on February 1, 2005, at 14:25:25
In reply to Re: I take Lamictal and I'm Pregnant, posted by banga on February 1, 2005, at 14:11:08
Here's something I found for you:
http://www.foxnews.com/story/0,2933,140832,00.html
"Depakote is one of the most widely prescribed anti-seizure drugs. In one ongoing study, one in four children born to mothers who took the drug during pregnancy experienced serious adverse events including birth defects and developmental delays. That compared to an adverse event rate of around 10 percent in children exposed in the womb to the antiseizure drug Tegretol and a 1 percent adverse event rate among children exposed to the drug Lamictal"
Although this is good news about Lamictal, I am dubious of the rate reported for Depakote. I can't believe the rate would be elevated to anything near 25%.
- Scott
Posted by Angielala on February 1, 2005, at 14:40:03
In reply to Re: I take Lamictal and I'm Pregnant, posted by banga on February 1, 2005, at 14:11:08
I checked that out and the MGH Women's Center... whom specialize in this area- however I cannot afford the $300 a visit it costs to be evaluated and all... they offer one free visit where they tell you that you need more visits.
It's so hard! I hope when my kids are older, there is all kinds of help for this.
How come rich people are able to be healthy and peopel with middle and low incomes are forced to be "sick"?
AHHH!
> Did your search for information include the Harvard Women's Mental Health info on the web? YOu probably did, but just checking because they have a whole research division that looks at medication and pregnancy. Maybe if you tried to work through the names mentioned there, they could give you advice as to who you could go to? Maybe someone even is covered by your insurance, who knows.....
Posted by lizbeth on February 2, 2005, at 9:37:33
In reply to Re: I take Lamictal and I'm Pregnant, posted by Angielala on February 1, 2005, at 14:40:03
Hi,
Sorry if this is a duplicate, thought I sent last night.
I took Lithium (1200 all the way up to 1800 with blood volume doubling during pregnancy), Lamictal (50 all the way up to 300) and even Seroquel 75 mg towards the end of my pregnancy for anxiety (couldn't take klonopin). I gave birth to a gorgeous, perfectly healthy baby girl by Ceasarean (probably because she was 9 pounds, 10 ounces and almost a week and a half late). She's almost 5 months old now and the pediatrician just gave her a clean bill of health. Some theorize that Lithium babies can be a bit bigger (something connected to insulin?). I am 5'11" though.
I went to a High risk obstetrics group at a teaching hospital and they were perfectly comfortable with it. The lamictal didn't concern them it all, it was the lithium that they wanted to monitor through a 17 week ultrasound to determine if a rare, Ebstein's anomaly (which isn't fatal and can be mild) was discovered. Once I got the all-clear for that, there were no other concerns for rest of the pregnancy.
My high risk group was called Maternal Fetal Medicine. They are actually within the hospital itself. They treat multiples, epileptics, diabetics, and other folks like me that have to take certain meds while pregnant. There was no question that I had to stay on them.
Don't let ill-educated primary care docs or obscenely insensitive general ob-gyn's (one told me I should have a surrogate) get you down. It's important to keep your self stable and happy, for the sake of the baby :)
Best,
Elizabeth
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