QUESTION:
Dear Dr. Heller,
I recently found out I'm pregnant (I'm 14 weeks). After my first trimester, my OB gave me Zoloft to treat my severe mood swings. I was diagnosed with BPD 7 yrs ago. Recently I was told that meds didn't help people with my condition and that I needed cognitive behavioral therapy, so I haven't been on any meds. Anyway, I'm very concerned about the effects of drugs on my unborn baby, but my pregnancies are very dramatic and I have many episodes of "freaking out". I don't know how else to describe it... mostly rages.
Have you done any studies or do you know of any studies on the treatment of BPD during pregnancy or breast-feeding? Most drug therapies aren't available and I don't know how to stop these extreme mood swings. Any help would be so appreciated by me, and my husband more especially, as he is generally the one who has to deal with these rages.
ANSWER:
Like so many other areas of medicine, it's a matter of risks versus the benefits.
Raging and being depressed during pregnancy appears to have a negative impact on the
unborn child. There's a serious shortage of information on the use of SSRI's
during pregnancy. So far no increased risk of birth defects has been shown.
Prozac is being used in children, and very small children can get depressed.
It's a decision you need to make with your husband, primary care physician,
obstetrician and mental health providers.
