Posted by Claudia Grazioso on January 20, 2012
I’ve known people who have battled depression, anxiety, OCD and insomnia and those are all difficult conditions — ones that sometimes require medication just to be able to function. But I have one friend who has bipolar disorder, and having watched her propelled through her days by mania and then collapsed in bed unable to move during her “down” periods, I have to say that that disorder strikes me as really, really hard to live with if it’s untreated. In fact, untreated bipolar disorder even seems like it could be dangerous. So I started thinking about what advice I would give my friend if she ever gets pregnant. Which led me to look into the class of drug known as mood stabilizers that are often prescribed to treat bipolar disorder as well as borderline personality disorder.
Lithium is considered the classic mood stabilizer and has been prescribed to treat bipolar disorder for years. Unfortunately, it can be dangerous for developing fetuses. Most SSRI drugs like Prozac and Zoloft that are used to treat depression have been given a Category C rating by the Food and Drug Administration. That means that studies on animals have revealed the potential for those drugs to harm fetuses, but no conclusive studies have been done on human fetuses. Lithium has been given a Category D rating, which is worse. Drugs that have been given the label of Category D appear to cause harm to human fetuses. In the case of Lithium, the main danger seems to be an increased risk for heart defects, specifically a cardiac defect known as Ebstein’s Anomaly, which affects the heart valves.
The risk seems to be the greatest if Lithium is taken through the first trimester of pregnancy. Also, babies whose mothers have taken Lithium throughout pregnancy have been born with Lithium toxicity, which can result in cyanosis, decreased muscle tone (hypotonia) and atrial flutters. Lithium was also found to pass into the breast milk and has even caused Lithium toxicity in nursing infants.
These are, of course, all situations that any mother hopes to avoid. But for moms with bipolar disorder, it can be a hard decision. Untreated drastic mood swings can also have a negative impact on both an expectant mom and a developing baby. If you live with bipolar disorder and become pregnant, do not simply stop taking your medication. Talk to your doctor about the risks and benefits of staying on Lithium, and the possibility of trying a lower dose for the duration of your pregnancy. Whatever you do, be sure to check with your healthcare provider before making any changes to the management of your disorder.