Q. I have been on lithium for roughly ten years. I was hospitalized for manic
episodes in 1991, 1996 and 1998. Since 1998 I have been taken Depakote and
Zyprexa in addition to the lithium and have also been taking Paxil for 6 mo.
or so. I am 35 years old and my clock is ticking. I would like to have a
baby but know I would be taking risks to my health by going off lithium and
Depakote and would be risking the baby's health by staying on it.
My doctor does not have much experience with this situation and is sending me
to a specialist (part of the Women's Mental Health Clinic or something part
of University Hosp. of Cleveland). My appointment is not for a month and
this uncertainty is keeping me up nights. I guess I am look for answers if I
can't get guarantees. Is there ANYTHING I can do to minimize my risk of
another manic episode? Is this condition genetic? If I can't take lithium or
Depakote, is there anything safe I can take to get me through conception and
the first trimester?
A. There are a number of medications you can take that will probably be safe for
the fetus. Sleep at night, wait for the appointment, and then get on the one
your doctor will suggest. Risperdal and Zyprexa are probably both safe in
pregnancy, and can help. There are even reports out of Boston that Depakote
is actually okay to use during pregnancy. See what the doctor suggests, since
they will be the person monitoring you. There are safe options out there.

