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Mental health folks want me on drugs but I am pregnant...

(23 Posts)
LissyGlitter Thu 22-Oct-09 12:28:09

I have a history of what was probably Postnatal Psychosis. However, I am now 36 weeks pregnant, and have been off all medication (I was on anti depressants, anti psychotics and occasional tranquillisers) while pregnant, and have had no symptoms. However, the medical people (early intervention team) are making noises about me going back on some medication before the birth to stop me getting ill again.

I'm not too sure. Obviously I will do almost anything to stop getting ill again, but it feels odd to start taking drugs on the off chance that things might go wrong. I want to breastfeed as well, which will limit what I can take, and it worries me that the drugs could affect the baby. But then I really was very ill last time, and don't want to miss out on this baby's early days as well. The side effects (especially from the anti-psychotics and tranquillisers) were massive, and I would like to be "myself" for a bit. But what if "myself" is, well, mad?

Any advice?

stakethroughtheheartofgold Thu 22-Oct-09 12:33:16

was the onset of the psychosis sudden last time? were you resistant to taking meds then?

stakethroughtheheartofgold Thu 22-Oct-09 12:34:23

btw i have to go out now but will check back later.

skihorse Fri 23-Oct-09 10:10:32

hi Lissy First of all, congrats on your pregnancy! I wanted to ask, what's your experience of anti-psychotics? The reason I ask is that I've used olanzapine and rispidal in the past and I found them both to be very fast-acting. What I mean is, when I was feeling "much improved" I did not take them regularly. I had a supply and if I felt myself losing touch with reality I could take a dose and found that they would calm me within 20 minutes... so I wondered if this might be an option for you?

The side-effects were for me that basically within 30 minutes of taking them I needed to be in bed because I was going to fall asleep where I fell. I would then wake up in the morning much more calm and of course I couldn't do anything "mad" when I was sleeping. Come the next morning things would seem a little better and I could call my team for help, or take another dose.

LeonieBooCreepy Fri 23-Oct-09 10:17:35

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LeonieBooCreepy Fri 23-Oct-09 10:18:06

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morningpaper Fri 23-Oct-09 10:22:23

Hmm Lissy I can see why you are a bit hmm

What drugs are they suggesting you take? How fast did they work last time?

I think you are right to question what options are available to you. What might be an idea is to contact your local branch of Mind. Some branches have Advocacy services for service users. It might be good to go over things with an advocate, who is trained in this sort of thing, and then either take the advocate with you to the GP, or decide how you are going to approach things.

It might also be worth discussing with your GP / early intervention team an alternative plan e.g. you will ring X (GP/early intervention team) every day, or you will discuss this with your midwife every day, or something like that. Make sure that your risk status is scrawled all over your notes so that everyone responsible for your care knows the risks and looks out for you.

Is your partner helpful? What is his opinion?

LissyGlitter Fri 23-Oct-09 12:41:36

skihorse I really don't know how effective the drugs were, tbh. I did carry on getting worse after I started taking them, but then who knows how bad I would have got without them? I can't remember the first one I was on (tbh I have very poor memories of a lot of things from the past two years, which are also the first two years of DDs life ), but that made me really sleepy and lethargic, and I absolutely piled on the weight, to the point where I was told to diet on medical advice (previously I had always been quite severely underweight). I eventually managed to persuade them to change me onto aripiprazloe (no idea how to spell that!) which was loads better and I felt like I had got my life back. I still had symptoms though, but like I say, I have no idea if they would have been worse without the drugs. I was also on sertraline, but again, I didn't see an improvement when I started them, so no idea if they were stopping me getting worse or what. If I missed a dose of either, I would feel weird for up to a week, so I don't think just taking them when symptoms started would work. The tranquillisers were just for emergencies, basically to knock me out so I couldn't do anything mad, like you say, although I did find it annoying that, when in hospital, the staff would insist on me taking the maximum dose at all times, even though I was very calm and well-behaved in general.

stake last time it started with what I thought was some kind of post traumatic stress from the birth, I would get flashbacks and nightmares, then it gradually spread to other areas of my life. I just thought I was tired, but when the mw did the pnd questionnaire, it was enough to make her make me go straight to the GP, within the hour. He put me on setraline, and then a CPN came to my house and had a chat, and she got alarmed and referred me to the early intervention team, who eventually put me on anti-psychotics. DD must have been about six months old by that point.

morningpaper DP is lovely, he really is brilliant about the whole thing. He can generally spot when I am going loopy and will tell me, he also has all the contacts for people to ring about me if need be, and I have signed all the forms so they will discuss my case with him if needed. Mind is a good idea, I will go and look them up now.

I dunno, I just think that the things that triggered the problems last time (traumatic birth, first baby so I didn't know what to expect, the sheer boredom of only having a newborn as company, having only just got together with DP, not eating properly, massive change of lifestyle, etc) shouldn't be there this time, so it seems a bit defeatist to go on the drugs without any symptoms. Then again, if I was at risk of a physical illness, I would take drugs to stop it, so why would a mental illness be different?

I am kind of reluctant to label myself as "mental" again as well. Although I suppose loads of people are on drugs like these and live completely normal lives, it doesn't mean that things will end up like last time again.

I'm pretty certain I will be able to spot if I start getting ill again.

morningpaper Fri 23-Oct-09 12:45:38

It sounds like you have a lot of support and are making rational arguments for your case. I hope Mind are helpful - if not come back here and I'll see if I can think of anything else!

stakethroughtheheartofgold Fri 23-Oct-09 13:07:13

speaking purely personally, i wouldn't take meds with massive side effects purely as a preventative measure.

it sounds as though you have a strong support team (professional and personal) in place who should be able to spot pretty quickly if things are going downhill and nip it in the bud.

as you rightly point out this birth/newborn period will be a different experience (which obviously may be stressful in different ways) and there are no sure things in mental health especially with hormones involved. (e.g. with my history of recurrent depression everyone assumed i was a shoe-in for pnd but it turns out i find bf hormones protective against depression).

does your dp have any thoughts one way or another about the meds?

LissyGlitter Fri 23-Oct-09 13:15:20

stake no, he is doing his usual annoying-yet-brilliant thing of saying he will support me 100% in whatever decision I make (he's the same with childbirth - lovely, but I kind of wish he would express an opinion on the matter)

bigstripeytiger Fri 23-Oct-09 13:23:38

Have you been able to have a detailed talk about this with your psychiatrist? Have they said what the chance is of you becoming unwell again, or what the prognosis would be if you were to become unwell?

If i was in the situation of having had a very severe postnatal illness, with a need for antipsychotics and inpatient hospital care, and if the risk was reasonably high that it would happen again (for me that would probably be anything worse that 1 in 3 chance of it happening again), then I would take the medication, in the hope that I would stay well, and hopefully be able to come off it fairly quickly, rather than risk another episode, but thats just the way I would weigh it up. I think also if there had been any risk to myself or the baby because of the illness that would also make me keen to take medication.

flakecake Fri 23-Oct-09 18:05:57

Hi Lissy,
Have you decided what to do? I was very ill after I had my DD, but if I was pregnant again I would attempt to stop all my meds or be on the lowest possible dose. I have heard some horror stories about these type of drugs we take at times and fetal development. Not good. So I agree with stake.

skihorse Sat 24-Oct-09 09:13:04

hi lissy - how are you feeling now? I think there's been some great advice and support for you here and I was wondering about another slightly subversive tactic... wink It sounds as though your partner is really supportive and I was wondering if you could just tell the pysch team that you are taking them... but wait until you feel you need them. You know in the same way that health visitors have a way of recommending something duff and you say "yes of course" and then go and do your own thing anyway. wink

bigstripeytiger Sat 24-Oct-09 10:51:37

I wouldnt lie about taking medication if you arent. If you are well enough to make decisions for yourself, and choose not to take medication then that is a perfectly valid choice, and you have no reason to hide that.
Also if your doctor thinks that you are taking medication, and you become ill, then they will then think that that medication hasnt worked for you, and they possibly will then want to change your medication to something else, when actually that might not be needed.

cupcake123 Sat 24-Oct-09 13:34:56

Lying about whether or not you are taking your meds is a really stupid idea. It is very likely to piss one's mental health team off in a big way - how on earth are they supposed to help someone who won't even tell them the truth about something as simple and important as that? I think that's very poor advice.

stakethroughtheheartofgold Sat 24-Oct-09 13:54:48

thirding what tiger & cupcake said

skihorse Sat 24-Oct-09 15:29:25

I'm sorry you feel it's irresponsible. I feel sad that OP is perhaps being railroaded in to taking medications that i) she is not comfortable taking during pregnancy, ii) she does not feel at risk right now and iii) she has a support team in place. I'd like to feel she can make her own choices for her body. I would have thought that those who have experienced such severe mental distress in the past would've been more understanding of this position because they should know better than anybody who ghastly it is to be told you are out of control/cannot be trusted unless you do.as.you.are.told.and.take.your.meds.

bigstripeytiger Sat 24-Oct-09 15:33:22

Skihorse

I think the point is that if she is well enough to make her own decisions then the OP is perfectly entitled to make choices about medication, and to have that respected by her doctors. No need to lie about what she is doing.

ImSoNotTelling Sat 24-Oct-09 15:46:38

Just to shove my oar in blush bear in mind that at 36 weeks the most sensitive developmental stages are done and it's mainly just growing. Plus it's probably a short term proposition, as baby will be here in the near future!

FWIW I suffered terrible perinatal depression and anxiety and have decided that if I have another baby i will take meds, I can't risk ending up like that again.

Lissy I think you need to talk your concerns through with your mental health people, how long the drugs take to have an effect, and possible side effects for you and the baby, and make your decision.

stakethroughtheheartofgold Sat 24-Oct-09 16:37:07

skihorse i don't get the impression that lissy is being railroaded into anything. she mentioned that they were "making noises", that's all. it sounds as though she has thought it through at length and in detail and is certainly able to express her reservations very clearly to us (although i realise it can be different when faced with professionals). she also has personal backup from a dp who is happy to support her in her choices. it sounds to me as though she is in a strong position to stand her ground against professional recommendations if that is what she decides to do.

i don't get the impression that she is being told that she is either out of control or cannot be trusted, simply that she may want to consider meds as a preventative measure. surely lying about taking meds is exacty the kind of thing that would make the professionals believe she wasn't trustworthy if it later came to light?

alwayslookingforanswers Sat 24-Oct-09 16:43:49

agree that lying would be the worst thing to do.

LissyGlitter Sun 25-Oct-09 16:34:59

I'm pretty sure it would count against me to lie as well - if I got found out, that could be used as ammunition to have me sectioned if I do have a relapse, which is obviously the very last thing I want.

Atm, the mental health team are happy with how I am, there are absolutely no concerns, and they have said that a factor in this is that I have never completely opposed (sometimes questioned) treatment when it has been absolutely needed, so they are happy to let me make the decision myself when it isn't clear what should be done.

I am leaning towards trying without the meds. I honestly don't feel at all unwell, and nobody else has expressed any concerns either. Last time I was pretty depressed during the pregnancy (although I was in a bed situation, so not sure how much was depression and how much was just a rational reaction) but this time I am just normally hormonal.

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