Expert: Ivan Goldberg, M.D. - 1/29/2004

Question
Hi,
 I am a 24 yr old woman who was diagnosed with Bipolar Affective Disorder and Panic Disorder/Agoraphobia appx 6 years ago. I also have two protruding disks that are pinching a nerve causing extreme pain and muscle spasms. I recently found out that I am pregnant (appx 3 to 5 weeks). I spoke with my GP who is managing my meds about what I should do but I would like as much advice as possible (my first OBGYN appt is not until Feb 10).

I was taking Lith Carb 300mg BID, Lexapro (not sure of the generic name) 20mg a day, Diazapam 5mg TID and Hydrocodone 7.5mg TID. My dr told me to DC the Lithium but to continue the others.

I am a grad student in psychology and have a great interest in studing/researching medicine esp. psychopharmaceuticals. However, I have yet to find any informative studies on the net and haven't had the chance to go to the library to look at journal articles.

I was hoping that you could give me any advice or info on these meds and their effects on the neonate or any kind of reference materials. Any help would be greatly appreciated. Thanks so much, Jessica S.

Answer
Hi . . .

I discourage my patients who take lithium and who become pregnant to take lithium during the first trimester of a pregnancy IF IT CAN SAFELY BE STOPPED.  While there is an increase in serious fetal malformation associated with lithium I have had four women who took lithium through five pregnancies and give birth to healthy babies.

To research this topic please go to:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
and type in   lithium AND pregnancy

Best regards . . .

Ivan
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