Expert: Ivan Goldberg, M.D. - 2/16/2008

Question
When I found out I was pregnant, I was taking my regular bi-polar meds for about 4 weeks (Abilify and Celexa).  My psychiatrist had me stop them and I didn't take any psych meds till I was at 14 weeks.  She prescribed Prozac (10mg first 4 days, then 20mg 1x/day), and Stelazine (2mg morning and night, then 2mg morning and 4mg night).  My OB/GYN and a high risk OB he consulted stated the Prozac and Stelazine were okay to take.  However, I am scared to death to be on these while pregnant.  I've read too much material stating the ill effects of Stelazine and the ill effects of Prozac use in the third trimester on the fetus.  

Can you let me know if these 2 drugs are a safe choice for my bi-polar?

Answer
Hi, Jennifer . . .

I have been unable to find any reliable information regarding  the possible impact of third trimester administration of Stelazine.

When it comes to Prozac there are conflicting reports. Some show an increased incidence of perinatal complications and others suggest that Prozac is pretty benign during the third trimester.

There is no way that anyone can say that the use of these drugs during the last trimester of pregnancy is totally harmless, but there is good evidence that women with a diagnosis of bipolar disorder, who take no medications during the third trimester of pregnancy are in increased risk for post-partum depression and psychosis.

If my wife were in your situation, I'd rather see her accept the risks associated with Prozac and Stelazine than go through the last trimester of pregnancy unmedicated.

Best regards . . .
Ivan
%