Whenever I attended a NAMI or NARSAD conference during the past ten years, I asked the medical panel the same question—albeit a hypothetical one for me at the time: Is it safe to take anti-psychotic medication if a woman is pregnant? Since the moment in April 1990 when I realized that I needed to stay on my medication for schizophrenia, I’ve feared getting pregnant while on Trilafon. It’s loomed like a teetering boulder poised atop a steep cliff and ready to roll who-knew-where. Would a developing fetus absorbing my prescribed pill be damaged at birth, harbor a time bomb of unknown suffering years down the road, or, my hope beyond hope, actually be healthy?
Until 1998, the responses I received at the conferences remained remarkably consistent with two replies: 1. Not much research has been done in this area, so not much is known; 2. The conventional wisdom is for women to go off their medications at least from conception until the first trimester when the major organs develop.
Great, I thought, I had finally accepted that I needed to stay on my medication only to find out if I wanted to grow a baby, I’d need to go off it. That thought scared me more than having a baby with birth defects. And it wasn’t just a weekend medication holiday—conceiving could take anywhere from six months to a year. Underneath my question sat relief that I didn’t really have to face the issue.
Then in 1998, I heard something different. I attended a NARSAD conference, asked my question of the panel and received the usual replies. But immediately following the session, three women walked over to speak to me. They all had daughters who were diagnosed with schizophrenia and who had given birth to healthy children. Two of the daughters became pregnant while on medication, and one daughter went off her medication but became psychotic after the baby was born.
Soon after the conference, I discovered that my gynecologist had worked with psychiatric patients on Mellaril or Haldol during her residency. She told me that these patients’ babies had been born healthy. According to my gynecologist, the most difficult pregnancies occurred when women went off their medications. “Being psychotic is more harmful to a fetus than anti-psychotic drugs,” she said.
She went on to explain that there usually was a difference in thinking between the ob-gyns and the psychiatrists—the ob-gyns preferred women to stay on their medication and the psychiatrists advised women to go off it initially. But, she explained, the differences between their thinking made sense. Since the women remained under their psychiatrists’ care, if the psychiatrists prescribed medication and the babies were born with birth defects, the psychiatrists were at risk for being liable. The ob-gyns were not. From the ob-gyn perspective, the psychiatrists in fact had little to risk because the ob-gyns knew they were delivering healthy babies with mothers on medication, and saw the distress to the fetus when a mother became psychotic going off her meds. Psychiatrists, who didn’t witness actual prenatal and birth experiences to assuage their thinking, tended to act with caution.
The information from my ob-gyn combined with the grandmothers’ stories left me feeling more helpful about conception and being pregnant while continuing my daily swallow of Trilafon. The possibility of my becoming a biological mother, however, remained a hypothetical issue.
Until a year later. I had finally entered a loving relationship with a man who wanted to marry me and have children. I knew little research had been conducted on anti-psychotic medication and pregnancy, primarily because researchers were reluctant to experiment with human fetuses and also because the number of women on these medications who become pregnant have been relatively few over the years. Still, I tried in earnest to discover what was known. Some studies were done with Haldol and rats, but I found virtually no information for Trilafon or any of the newer anti-psychotics.
When I married and decided to try to have a baby, my own psychiatrist advised me to go off my medication before conceiving and throughout the first trimester. But by then some younger psychiatrists were rethinking that caveat. The new approach believed that the greater risk involved stopping medication. More and more often doctors told me that my age, 40 at the time, was a greater risk for a healthy pregnancy than taking medication. I was elated to have encountered such a mainstream risk factor.
My husband and I decided to try and conceive while I continued to take Trilafon. When, much to our delight, I became pregnant, we faced one more hurdle we hadn’t anticipated. Our genetic counselor raised the possibility that my Trilafon dosage, which was effective with my pre-pregnancy blood levels, might not work when my blood volume increased during the second trimester. Fortunately, my regular dosage continued to work throughout my entire pregnancy and postpartum period.
Growing a baby while taking anti-psychotic medication can be a reality. I have only to hold my two-month-old daughter in my arms to know this is true—and how lucky I am to have benefited from both the serendipity of hearing other women’s experiences and the changing attitudes within the psychiatric community.
Monday, October 10, 2011
A Pregnant Pause: Anti-Psychotic Medication And Growing A Baby
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Monday, October 10, 2011
A Pregnant Pause: Anti-Psychotic Medication And Growing A Baby
Whenever I attended a NAMI or NARSAD conference during the past ten years, I asked the medical panel the same question—albeit a hypothetical one for me at the time: Is it safe to take anti-psychotic medication if a woman is pregnant? Since the moment in April 1990 when I realized that I needed to stay on my medication for schizophrenia, I’ve feared getting pregnant while on Trilafon. It’s loomed like a teetering boulder poised atop a steep cliff and ready to roll who-knew-where. Would a developing fetus absorbing my prescribed pill be damaged at birth, harbor a time bomb of unknown suffering years down the road, or, my hope beyond hope, actually be healthy?
Until 1998, the responses I received at the conferences remained remarkably consistent with two replies: 1. Not much research has been done in this area, so not much is known; 2. The conventional wisdom is for women to go off their medications at least from conception until the first trimester when the major organs develop.
Great, I thought, I had finally accepted that I needed to stay on my medication only to find out if I wanted to grow a baby, I’d need to go off it. That thought scared me more than having a baby with birth defects. And it wasn’t just a weekend medication holiday—conceiving could take anywhere from six months to a year. Underneath my question sat relief that I didn’t really have to face the issue.
Then in 1998, I heard something different. I attended a NARSAD conference, asked my question of the panel and received the usual replies. But immediately following the session, three women walked over to speak to me. They all had daughters who were diagnosed with schizophrenia and who had given birth to healthy children. Two of the daughters became pregnant while on medication, and one daughter went off her medication but became psychotic after the baby was born.
Soon after the conference, I discovered that my gynecologist had worked with psychiatric patients on Mellaril or Haldol during her residency. She told me that these patients’ babies had been born healthy. According to my gynecologist, the most difficult pregnancies occurred when women went off their medications. “Being psychotic is more harmful to a fetus than anti-psychotic drugs,” she said.
She went on to explain that there usually was a difference in thinking between the ob-gyns and the psychiatrists—the ob-gyns preferred women to stay on their medication and the psychiatrists advised women to go off it initially. But, she explained, the differences between their thinking made sense. Since the women remained under their psychiatrists’ care, if the psychiatrists prescribed medication and the babies were born with birth defects, the psychiatrists were at risk for being liable. The ob-gyns were not. From the ob-gyn perspective, the psychiatrists in fact had little to risk because the ob-gyns knew they were delivering healthy babies with mothers on medication, and saw the distress to the fetus when a mother became psychotic going off her meds. Psychiatrists, who didn’t witness actual prenatal and birth experiences to assuage their thinking, tended to act with caution.
The information from my ob-gyn combined with the grandmothers’ stories left me feeling more helpful about conception and being pregnant while continuing my daily swallow of Trilafon. The possibility of my becoming a biological mother, however, remained a hypothetical issue.
Until a year later. I had finally entered a loving relationship with a man who wanted to marry me and have children. I knew little research had been conducted on anti-psychotic medication and pregnancy, primarily because researchers were reluctant to experiment with human fetuses and also because the number of women on these medications who become pregnant have been relatively few over the years. Still, I tried in earnest to discover what was known. Some studies were done with Haldol and rats, but I found virtually no information for Trilafon or any of the newer anti-psychotics.
When I married and decided to try to have a baby, my own psychiatrist advised me to go off my medication before conceiving and throughout the first trimester. But by then some younger psychiatrists were rethinking that caveat. The new approach believed that the greater risk involved stopping medication. More and more often doctors told me that my age, 40 at the time, was a greater risk for a healthy pregnancy than taking medication. I was elated to have encountered such a mainstream risk factor.
My husband and I decided to try and conceive while I continued to take Trilafon. When, much to our delight, I became pregnant, we faced one more hurdle we hadn’t anticipated. Our genetic counselor raised the possibility that my Trilafon dosage, which was effective with my pre-pregnancy blood levels, might not work when my blood volume increased during the second trimester. Fortunately, my regular dosage continued to work throughout my entire pregnancy and postpartum period.
Growing a baby while taking anti-psychotic medication can be a reality. I have only to hold my two-month-old daughter in my arms to know this is true—and how lucky I am to have benefited from both the serendipity of hearing other women’s experiences and the changing attitudes within the psychiatric community.
Until 1998, the responses I received at the conferences remained remarkably consistent with two replies: 1. Not much research has been done in this area, so not much is known; 2. The conventional wisdom is for women to go off their medications at least from conception until the first trimester when the major organs develop.
Great, I thought, I had finally accepted that I needed to stay on my medication only to find out if I wanted to grow a baby, I’d need to go off it. That thought scared me more than having a baby with birth defects. And it wasn’t just a weekend medication holiday—conceiving could take anywhere from six months to a year. Underneath my question sat relief that I didn’t really have to face the issue.
Then in 1998, I heard something different. I attended a NARSAD conference, asked my question of the panel and received the usual replies. But immediately following the session, three women walked over to speak to me. They all had daughters who were diagnosed with schizophrenia and who had given birth to healthy children. Two of the daughters became pregnant while on medication, and one daughter went off her medication but became psychotic after the baby was born.
Soon after the conference, I discovered that my gynecologist had worked with psychiatric patients on Mellaril or Haldol during her residency. She told me that these patients’ babies had been born healthy. According to my gynecologist, the most difficult pregnancies occurred when women went off their medications. “Being psychotic is more harmful to a fetus than anti-psychotic drugs,” she said.
She went on to explain that there usually was a difference in thinking between the ob-gyns and the psychiatrists—the ob-gyns preferred women to stay on their medication and the psychiatrists advised women to go off it initially. But, she explained, the differences between their thinking made sense. Since the women remained under their psychiatrists’ care, if the psychiatrists prescribed medication and the babies were born with birth defects, the psychiatrists were at risk for being liable. The ob-gyns were not. From the ob-gyn perspective, the psychiatrists in fact had little to risk because the ob-gyns knew they were delivering healthy babies with mothers on medication, and saw the distress to the fetus when a mother became psychotic going off her meds. Psychiatrists, who didn’t witness actual prenatal and birth experiences to assuage their thinking, tended to act with caution.
The information from my ob-gyn combined with the grandmothers’ stories left me feeling more helpful about conception and being pregnant while continuing my daily swallow of Trilafon. The possibility of my becoming a biological mother, however, remained a hypothetical issue.
Until a year later. I had finally entered a loving relationship with a man who wanted to marry me and have children. I knew little research had been conducted on anti-psychotic medication and pregnancy, primarily because researchers were reluctant to experiment with human fetuses and also because the number of women on these medications who become pregnant have been relatively few over the years. Still, I tried in earnest to discover what was known. Some studies were done with Haldol and rats, but I found virtually no information for Trilafon or any of the newer anti-psychotics.
When I married and decided to try to have a baby, my own psychiatrist advised me to go off my medication before conceiving and throughout the first trimester. But by then some younger psychiatrists were rethinking that caveat. The new approach believed that the greater risk involved stopping medication. More and more often doctors told me that my age, 40 at the time, was a greater risk for a healthy pregnancy than taking medication. I was elated to have encountered such a mainstream risk factor.
My husband and I decided to try and conceive while I continued to take Trilafon. When, much to our delight, I became pregnant, we faced one more hurdle we hadn’t anticipated. Our genetic counselor raised the possibility that my Trilafon dosage, which was effective with my pre-pregnancy blood levels, might not work when my blood volume increased during the second trimester. Fortunately, my regular dosage continued to work throughout my entire pregnancy and postpartum period.
Growing a baby while taking anti-psychotic medication can be a reality. I have only to hold my two-month-old daughter in my arms to know this is true—and how lucky I am to have benefited from both the serendipity of hearing other women’s experiences and the changing attitudes within the psychiatric community.
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