Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Bipolar and pregnancy

4 April, 2005

Question:

Regarding your answer in 1041 (bipolar):

My physician, a psychiatrist treating me for bipolar, has had a favorable experience in treating other pregnant patients using Zyprexa. (I myself was able to remain off of medication for conception, pregnancy, and nursing, but had the medication on hand in case of psychosis.)

A patient must be aware, however, that the standard of care (in the US) is that monitoring of the fetus while taking medication such as zyprexa or lithium is done with the physician expecting that the patient will terminate the pregnancy if a gross bodily deformity is noted. It's important for the woman trying to get pregnant to let her obstetrician and psychiatrist know that termination should not be considered as part of the treatment options.

While pregnant I often consulted the government sponsored web-site, CTIS, to check the teratogenicity of medications. I found this resource more up-to-date than my physician's limited experience.(I also have asthma, so had to take medication for that.) http://ctispregnancy.org is the link, and the home-page has Spanish resources, as well.

As an aside, I had difficulty locating a psychiatrist willing to accept me as a patient when I expressed the desire to become pregnant. I was frankly told that the fear of liability precluded my being considered as a patient. I was thank god able to find a physician not once but twice (as we moved), and now am mother to three sons.

Thank you for your service. I hadn't realized that I have the status of nursing until I read your web-page questions.


Answer:

Thank you for the information and the link.  We hope to help increase awareness of these issues.


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