Expert: Ivan Goldberg, M.D. - 7/24/2010

Question
Hello,
I am planning to become pregnant. I am on a low dose combination of Lexapro, Wellbutrin, and Lithium.  These are absolutely critical for me to live. I have tried to switch medications to something safer on several occassions with an extremely bad outcomes. My psychiatrist and I have decided that the best option for ME is to stay on the doses I am on through pregnancy, though I have read that this may have potentially poor (even devastating)outcomes for a developing fetus.  Therefore, I am considering the possibility, with my providers, of taking less medication at the time of conception, 1st trimester,and last. (this will hopefully minimize effects on heart and lungs) Again, that is, if it is possible.  
I have read the frightening risks.
My main question is: Have you SEEN any women go through pregnancy on these meds, or any combination of them? What has been the outcome for these babies and their moms?
Thank you.  I know that no one can tell me that it will be OK; I am just looking for actual FIRSTHAND accounts rather than secondhand stories or statistics, which is all I have been able to find until now.

Answer
Hi Adrienne,

You seem aware there are few activities that are totally risk free. The risks attached to the use of psychiatric meds during pregnancy involves some risk but the vast majority of women who take lithium and other medication during pregnancy deliver normal babies. I started using lithium about 7 years prior to it being approved by the FDA for general use in the USA. Over 10 of my patients have had a total of 15 or 16 babies while taking lithium and all of the babies were fine. While none of my patients took exactly the the combination of medications you mention, a number of them took one of the SSRIs + Wellbutrin + lithium and had healthy children.

It is VERY important to differentiate between possibilities and probabilities. It is possible that the sun will turn into a supernova within the next hour and we will all be incinerated, but it is not at all probable. With the medications you mention it is probable that your baby will be healthy

Best regards . . .

Ivan
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