AboutDr Alan Galbraith Expertise I can answer most questions on most drugs. Answers can be given in either technical or layperson terminology. My main areas of interest are psychiatric, gastrointestinal and cardiovascular drugs.
Experience I have been a university lecturer/head of department for almost thirty years, but am now retired. My research interests were alcohol, smoking and cardiovascular disease.
Organizations Institute of Biology, London.
Publications Author of "Fundamentals of Pharmacology" 5th Edition published in November 2007 by Pearson Education, Australia.
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 Dear Jessica
I'll give you a short note on each drug and I agree with your doctor's advice but no one would guarantee complete safety for any of these drugs. One must way the benefits against the possibility of adverse effects which are very unlikely except with lithium. I would not worry about the fact that you were taking lithium before you knew you were pregnant. Please refer to what I have written below.
Lithium carbonate is a category D: Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage.
The risk of birth defects may be increased when lithium is used during the first trimester. Second trimester detailed ultrasound examination and fetal echocardiography should be considered for women who have been treated with lithium during the first trimester of pregnancy. The newborn may show signs of lithium toxicity.
Benzodiazepines such as diazepam may cause temporary hypotonia (weak muscles), respiratory depression and hypothermia in the newborn infant if used in high doses during labour. Withdrawal symptoms in newborn infants have been reported with prolonged use of this class of drugs.
Opioid analgesics (hydrocodonew)may cause respiratory depression in the newborn infant (easily treated). Withdrawal symptoms in newborn infants have been reported with prolonged use of this class of drugs.
Selective serotonin reuptake inhibitors (SSRIs)including Lexapro have had limited use in pregnancy without a reported increase in birth defects. The use of SSRIs in the third trimester may result in a withdrawal state in the newborn infant.
These withdawal states are really nothing to worry unduly about. If they do occur they only cause minimal stress to the newborn for a short period of time.
I hope that this material will put your mind at rest.
