I need help any professionals out there? Post partum psychosis

[PoorFanjo]

I had a 17 week miscarriage recently ( I hate that word she was person but I digress), I'm on venlafaxine and quetiapine for ptsd and psychosis. I'm feeling really stable, I've done a week of emdr therapy and will be keeping up with it for a while.

My issue is, my GP has said my psychiatrist (who I pay for privately btw) can't prescribe any of my drugs if I chose to get pregnant again because they don't know the risks during pregnancy..

So I need to know what the nice guidelines are, do I have to come off my medications to have another baby? Or just change the medication? My psychiatrist is really happy with my progress but we're thinking of starting trying again in the next 8-9 months and I don't know if I'll still be on the medication by then? I will say the medication has made me feel amazing but is this me now? Just on anti psychotics and not able to have children because of it?

I got put on the medication because of post parting psychosis after my 17 week miscarriage and I'm ashamed of my actions but I know I was so unwell. Anyway I know it will put me at very high risk of having it again but I want a baby so badly ( not just yet I'm not ready just yet but soon)
Anyone had post partum psychosis and had another child?

I've not been in your situation and I'm so sorry for your loss.

I would say though that putting yourself and your mental health first would be the best option. Motherhood is hard on mental health and if you keep going and put yourself in the best possible position beforehand the transition will be a lot easier.

I wish I'd have worked on my emotional well-being more before I had children.

Good luck whatever you do, and well done on your recovery!

Please don’t ever be ashamed of what happened, it was not your fault & you have came through it. There is a specific Perinatal Mental Health team, that coordinates all your midwifery care, including your medications. Have a family member who had postpartum psychosis after baby No 1, went on to have baby no 2, under the care of the Perinatal team, stayed on maintenance dose of meds through pregnancy & dosage increased in last stage, plus very careful monitoring pre & after birth. You have a consultant lead pregnancy rather than local midwife led. But relative had a very successful 2nd pregnancy

There are plenty of medications safe.
I have ptsd, bipolar and bpd
After the birth of my second child I had post partum psychosis. I have now been medicated since the birth of my second child. I have since gone on to have a 3rd child.

Yes my medication made me high risk so I was consultant led. I also had Mother and infant mental health team who carefully monitored me and liaised with not only the maternity team at the hospital but anyone else involved at the time.
I had my 3rd during covid, but due to my birthing plan by MIMS I had my birthing partner with me for the 2 days we were kept in for (including over night) as we were in a separate room as I was high risk. Midwife didn't discharge us till day 28.

I had post partum psychosis and ended up being sectioned. Eight years later I fell pregnant unexpectedly. I asked to be referred back to the psychiatrist who monitored me during pregnancy. I felt incredibly well throughout much like with my earlier pregnancy but felt worried at what was to come.
Plan was to deliver and start medication after delivery. Anti depressants immediately (I'd had PND after my other children) and then adding in the rest as needed Lithium, prochlorperazine etc.
I started Lofepramine (which had worked last time) immediately but twelve days in I had an awful allergic reaction so had to stop taking it. Plan was then to let things settle and restart a new antidepressant but I actually felt well. I saw psychiatrist weekly and then fortnightly, then monthly and was discharged when baby was a year old never having restarted antidepressants and with no PND even.

I'm not an expert but I don't think either of those meds are contraindicated in pregnancy- it's always a risk/benefit discussion. BUMPS is a brilliant website for getting further info about meds/pregnancy.
medicinesinpregnancy.org/Medicine--pregnancy/Venlafaxine/
medicinesinpregnancy.org/Medicine--pregnancy/Quetiapine/
I'm sorry about your loss, and I'd agree with PPs that giving your mental health time to settle down now would be sensible. You should also be able to speak to the perinatal mental health team about your meds etc before making any decision- you should be able to ask to be referred for pre-conception discussions if you're not still under them.
Best wishes.

Hi,
Disclaimer that you should always take advice from medical professionals you have reviewed you and not from the internet
DOI: Psychiatrist

However as psychiatrist- Quetiapine relatively low risk in pregnancy
Venlafaxine is associated with some problems in literature and would recommended switching to sertraline
As you have had an episode of serious mental illness you are entitled to be referred to NHS perinatal services for pre conception counselling
Whatever you do don’t stop medications without a psych review

I have attached some screenshots from my textbook but they are aimed at professionals not patients

Also I’d recommend continuing on the medication for 12 months following the episode- not necessarily forever- can then look at weaning with very close review

@Dinopee that's so helpful thank you so much