Expert: Ivan Goldberg, M.D. - 1/13/2009

Question
Hi, I am bipolar and i have tried every med in the book and every med cocktail ,i guess i am sensitive to meds,and i was either sick form it,or it just didn't work,even lithium after 2 years didn't do the job.Right now i am on ZONEGRAM 200 mg and i feel great it really did the job,i also take 50mg of zoloft and 1mg of xanax daily,the question is, I AM PREGNANT .and worried,mostly about the Zonegram.What do you think?

Thanks
Lalita

Answer
Hi Lalita,

What I think is that you are in a VERY uncomfortable situation. The problem is that there is not very much information on the impact of Zonegran in the developing fetus. I am sure you did a Google search and read what is written on the Web about Zonegran and pregnancy. If you go to Pubmed (get to it via Google) and do the following search without the quotation marks( you will find everything in the medical literature on the topic: "zonegran AND (pregnancy OR fetus OR lactation) AND human" On the upper left side of the screen you will see a window that says "Summary" of you change that to "Abstract" you will find abstracts of those publications that have been abstracted.

In any case, my reading of the literature is that Zonegran may increase the risk of fetal abnormalities, but we know that pregnant women whose mood disorder is out of control also put their unborn babies at risk. Folic acid is suggested during pregnancy, especially the first trimester is suggested as a way of lowering the risk to the fetus.

What women decide to do in situations such as yours is a function of their personal philosophies, religion, attitudes toward risk-taking, attitude toward abortion, etc.

I'm sorry I cannot be more helpful regarding your difficult situation.

Best regards . . .

Ivan
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