33 weeks pregnant and a decision to make ...

[Bookwormprincess]

I haven't been on the forum for a couple of months now, but I have a big decision to make and was wondering whether anyone had any advice, epsecially those with experience of PP and anti-psychotics.

My preventative plan 2nd time round has always been to take anti-depressants throughout the pregnancy and then go straight on anti-psychotics after the birth, in order to try and prevent PP re-occuring. However, there is a new peri-natal pyschiatric service that has come online in Kent called MIMHS (Mothers and Infant Mental Health Service) and my Dr and care team have met with their consultant Dr, who strongly recommends taking anti-psychotics during the 3rd trimester as a more effective preventaive measure, because she says if it does happen again, taking it after delivery may not be enough to stop it in time (although of-course it's better than taking it after it has started or established itself). We are talking to this consultant tomorrow with lots of questions to help us decide what to do. The pediatrician has said it will have no developmental effects on the baby at this time, so he has no concerns there, but there will be short term withdrawal to deal with and he'll get back to us when he's looked into what to expect, but intitially he said it would only be a short term problem for the baby if anything.

I am undecided at the moment and need more info. But I am very scared of having another episode so want to do all I can to prevent it, however am I prepared to take more medication during pregnancy and one that made me feel numb and gain weight rapidly. I was kind of prepared for that after birth, but not before. It's the emotional numbness I fear the most from them, but that would be way better than becoming psychotic again. However, do I want to feel numb when my son is born? No, of-course not. No-one can tell me that the meds will make me numb again, but to be honest I felt so much better so quickly when I came off them, I'd be surprised if it wasn't the medication that made me feel that way.

Has anyone else on anti-psychotics felt emotionally numb and when you came off them did you feel back to normal really quickly like me? Does anyone know (Winegirl maybe? with your psych nurse training) how they could affect your moods if you take them when you are well and 'normal' for want of a better word?

A compromise (if I decide to take them at all) would be to take a low dose and see how I feel, and if I feel awful, i.e. numb and unemotional, then I can come off them again and just wait till I deliver. It really is a difficult decision, epsecially since there's a 50% chance I won't get ill again anyway, medication or not.

Your thoughts would be appreciated, but please be gentle with me as I am feeling quite scared of what may happen again to be honest. I did have a good cathartic cry with my husband the other night about it all, which I feel better for. I just wish I didn't have to think about any of this at all.

[monica]

Hello

Oh petal - it is such a big decision to make. I'm sorry but I can't give you any advice but just wanted you to know I'm thinking of you.

How did you feel at this stage in your first pregnancy? Do you feel better this time round? Was there any signs during pregnancy, that you might get PP looking back. I know one lady who had pp said that she had antenatal depression largely triggered by events which occurred during her first pregnancy. Whether the two are linked I dont' know.

Btw how long would you be on antipsychotics for? If it is a short term thing maybe taking them especially a low dose might put your mind at ease in terms of PP returning? Just a thought

Mayne write down all your questions for the dr so you don't forget what to ask. All the best and let us know how you get on.

Love

Monica

[louloubexs]

Hi Darling

After reading your post, I am sorry that you are struggling to come to an decsion. Having suffered PP and being under the Mims team myself Dr P is an expert in the field. However after speaking to her about pre advise she also told me and was decided between the both of us that I would take meds 12 hours after delivery. My husband and I have decided not to have any more children at present but haven't out ruled it completely. What dose would be you on, and would you be on quentipine or Olanzapine or have they decided to use another anti-pyschotic? Natasha this is purely from experience and what I

would do in your shoes. This is purely a personal reply and whatever you and your hubby decide will be right for you both.

I would not take any dose of anti-pyschotic during pregnancy not even in the 3rd Trimester unless I was displaying pyschotic symptons.
As if you are only taking a therpetic dose, which is what you would be taking would not stop a full blown episode, it may just mange break throught symptons, which you are not having.

Its after birth that you had the problems before not during with the PP. So say you were on a low dose say 200mg through your 3rd trimester, I fail to see how it would stop an episode as you had PP. Not Bi-polar so your hormones when loopy (like mine) after birth.

Its just withdrawals are bad enough, let alone for a new born. I dont want you to feel any guilt etc, which happens so commonly with us ladies that suffer with PNI.

I personally would take probably about 200mg after birth and if you start having symptons to tweek it. I have to say I didn't feel emotionally numb on the meds, for me thats just the illness.

Darling I am sorry if this sounds one sided, remember this is just my personal opinion. I feel if your going to get PP, it can be managed so quickly, as mine had 14 days to erupt before getting diagnosed, hence the 2 year recovery period. If it was caught in a day or two I hear the recovery is months not years.

Much Love xx

[Weeble]

Hi

Not sure I can be of any help, but I have had to think about similar issues over the past few weeks. I did not get PP, just severe depression, but have really struggled for the past eight months. since T was born. I am 4 months pregnant by accident, and am struggling with it.

A couple of months ago my psychiatrist started talking about using mood stabilisers to stop me cycling so badly. She felt the risk of the drugs was significantly less than the risk of my illness. At first I said outright no, but the more I thought and read about it the more I came round to the idea. In the end, changing the support I have and my OH have managed to keep me up enough that I dont have to take them currently. But in the end my decision was - the worse thing that can happen for me and my children is I am so miserable that the two older ones dont get looked after and the new one has an even harder time than the first two.

In the end I will make my decision about drugs over the next six months based on the following: what will do the most damage to the kids being really ill or taking some drugs. If faced with your decision I would decide what is worse the fear of PP and another bout of the illness or the impact of the drugs on today. In the end I would probably let myself be guided by the consultant and only the consultant.

Good luck in making your decision, and thinking about you.

let us know how it goes

Kat

[Bookwormprincess]

It's over a year now since I came back to this thread, but I did read everyone of your replies and your thoughts and advice was much appreciated.

As you probably all know by now I did prevent an episode of PP reoccuring and am planning on coming back and posting a thread about my careplan and all that happened afterwards. Even though what I did was specifically based on me as an idividual and how the pattern of my first episode, I feel writing it down may help others who have similar decisions to make.

My baby was critically ill which is why life has run away with me this past year and I have not updated you all. He is well and thriving now as you may have seen on facebook photos. You'd never know he went through a life-saving op at 2 days old! He's a delight and I can't wait to encourage you with how good it feels to be a Mum who is well and didn't have to contend with PP or PNI.

Back soon .... x

[Weeble]

Hi bwp

I remember you posting here and it's brilliant it worked for you. Have to be honest very envious as it didn't work so well for me and I only got my appointment with the perinatal specialist ten days after he was born because our pct would not pay, despite my gp and three separate consultants writing to them.

Still enough about me looking forward to hearing all about it and congratulations on such a success

Kat

[Bookwormprincess]

Oh Kat, I feel so angry that you were given such poor care. It's just not good enough. Maternal mental health should be a priority, instead sadly it is shoved in a corner and forgotten all too often; as long as the baby is well that is all that matters to some professionals.

I'd feel envious in your shoes too. It took a lot of hard work from my EIP team coordinating everything, it was harder than it should have been and I wouldn't have wanted to face getting the help set up for me without their backing. I promise to write about it in the not too distant future in the hope it might others in a similar situation.

When you feel strong enough and well enough perhaps as part of your healing you might want to give feedback to your pct about how they let you down. It doesn't matter if the feedback comes years later as it may still change the way mums are treated. Just a thought as I'm doing something similar about my stay in hospital and pathway to care when my first child was born.