quetiapine/bipolar disorder/pregnancy

[ddhh]

Hi all, I am new to the site so forgive me if I've posted this in the wrong section.
I was diagnosed with bipolar 2 in 2015, up until recently I was extremely depressed, suicidal and completely lost hope due to years of medication trials and changes. However recently my new psychiatrist put me on 300mg of Quetipine and instantly I started to feel better and I can honestly say I have never felt better in my life. I had never thought I'd be able to have a child due to this disorder and my coping abilities however as I started to feel better my partner and I discussed having a baby and, well now I am 7 weeks 2 days pregnant but my new psychiatrist has taken me off quetipine and I'm starting to feel depressed again and scared. My psychiatrist said I can start back on the medication at 3 months. I'm just wondering has anyone else been through something similar. I'm feeling pretty lonely too as were in lockdown and I don't see anyone and I do not have anyone I could discuss this with

Is your psychiatrist a general psychiatrist or a perinatal one? I would ask to be referred for a review with a perinatal team if not.
The guidelines for quetiapine has changed in the last couple of years and it is now deemed safe in pregnancy. I don't want to tell you to go against your doctor but if you are struggling it would be worth asking for a specialist for further opinions about options in early pregnancy.
I'm bipolar too and have been able to stay on my quetiapine throughout my pregnancy, obviously my team did a risk assessment for me personally based on my history and specific circumstances so it may not apply to you but it is worth asking the question.
I found a fact sheet by searching quetiapine and pregnancy which outlined the risks and things to consider

Hi superscientist, thank you for your reply! My psychiatrist is just a general psychiatrist. I told him I had stopped sleeping at night and his response was to sleep during the day instead he has said I can start back on the quetiapine at 12 weeks and to just wait it out really. Can I ask how you have been feeling throughout your pregnancy? Are you doing okay mentally? I'm really not liking these past few weeks and I'm just hoping for the time to pass to get back on quetiapine to start feeling like myself again. (As odd as that sounds)

My mood has gone a bit low, the sickness and fatigue gave me a bit of a kicking. I just don't have the energy to do anything I would usual do to manage my mood. Before pregnancy I was running 2-3 times a week, reading on my commute and before bed, doing pilates at weekends and craft projects. All of that has stopped and my mood is suffering as a result. I'm under the perinatal mental health team and they put in a referral for cbt to help me out - I am doing a 6 week online course with weekly phone calls to check in. I'm hoping that helps take the edge off things, if not I might need a medication increase. Due to increased size and blood volume it's not uncommon to need a higher dose later in pregnancy (I'm 23 weeks now).

Please see if there is a perinatal mental health team in your area. I was taking Quetiapine and sertraline for bipolar before i was pregnant and then continued the whole way through my pregnancy and throughout breastfeeding. The Perinatal team encouraged me to do this as they felt me being mentally unwell was worse for the baby. I stayed in for 48 hours after birth as the baby has to be monitored because of the medication, but she was absolutely fine. My midwife said they had never actually seen a baby with bad withdrawal symptoms.

I second the above, they cover quite a wide area too. I was given the same advice medicated and well is better than unmedicated and unwell. Guidance for prescribing in pregnancy changes so frequently your really need advice from a specialist team.

I'm glad your little one didn't have withdrawal and that bad withdrawal isn't common. It my main worry, I have been in withdrawal before when I forgot to take my pills on a weekend away and it was awful. I was dreading putting a newborn through that.

@Superscientist the midwives all said that newborns can all behave so oddly sometimes it is hard to know whether their behaviour is because of withdrawal or just being a newborn!

Hello
I could've written this post!
I'm not pregnant. We were going to start trying but due to the pandemic we've decided to pause TTC.

At Christmas time I decided to try and come off my medication. Seriously I was so unwell!
2 days in I hadn't slept an hour, was shakey, nauseous, couldn't stand up and slept then for 24 hours.
Is this normal?
Is it wise to be on meds when you want to conceive ?

And congratulations ❣️

Sounds like how I am when forget my meds and have withdrawal symptoms.
Did you come off under medical supervision?
Speak to your gp about what is best for you, we decided for me it was best to stay on but I reduced my dose from 600 to 400 over the course of 4 weeks - to minimise the impact.

Stupidly just did it myself. I am now on just 75 a day. I can't sleep or function with out it.
I can't see myself ever being drug free. I feel dependent

@Superscientist
@Orangesandlemons82
Hi guys so sorry for the late reply, I went drastically down hill with my mental health and seriously bad thoughts that I've had to go back on quetiapine. I made it to 8 weeks however it just got too bad so I am starting back on them tonight. I have to say reading your replies gave me strength to go back on them. I felt like a failure but honestly I do not think I would have coped for much longer without them. I was so happy when I found out I had become pregnant but being off my medication the depression took back over again and I've been questioning why I even tried to get pregnant in the first place. I see my psych again next week thankfully.

@BeautyinAutumn
Definitely speak with your GP/psychiatrist when considering coming off medication. I thought I would be able to handle it for the first trimester but I just couldn't and the pain of being mentally unwell along with morning sickness is pure torture

Quitiapine and pregnancy
I am too worried on this subject. Been on Q for 4 years and have been well no episodes. But due to such limited data on Q and pregnancy/ birth defects , I am scared to take it ( am not pregnant yet!) and scared not to take it! Take 200mg per night bi polar, doc has recommended starting to lower dose to see how I go .... any advice would be greatly Appreciated!! Xx