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Taking long term medicine for depression and anxiety. Planning for pregnancy. Concerned related medicine use

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Practicing since : 2004
Answered : 1852 Questions
I am 39 years, 5'4, 89 kgs got married 1 year back and want to plan a family now.Both me and my husband want a child.But a problem is that i was on medication for a long time for depression and anxiety and since past 2 years i am on Deepakote 250,Palaris 3 mg, Buspin 5 mg.
My psychiatrist told me to discontinue these medicines slowly but the problem is when i dont take them i dont feel completeley normal and comfortable like when i take them.I can stop them slowly ut will it be risky??
Since i want to get pregnant ,if i stop these medicines will my health be at risk?is it safe to stop.I do not have any problems and have been stable for past 2 years.
Will it be safe to be pregnant now considering 2 factors :am on medicine and not so easy to stop,might be risky and secondly my age factor. am almost 40 now.
Kindly advice .
Posted Thu, 21 Mar 2013 in Medicines and Side Effects
Answered by Dr. Ashish Mittal 1 hour later
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.
Important aspects of your query are:
•     39 year old female
•     Known case of anxiety and depression
•     Planning for pregnancy
•     Concern related to medicine use.

You are currently on Deepakote 250, Palaris 3 mg, Buspin 5 mg. In history although you are well for 2 years, but you do not feel comfortable on stopping them.

Use or stoppage of psychotropic medicines in pregnancy is a complex decision. Usually medicines are not preferred during pregnancy, specially in first trimester. But psychiatric illness like depression are chronic illnesses and may recur after stoppage of medicines, which can more harmful for baby in severe cases.

Use of medicine during pregnancy, do not have fixed answer. Final decision differ patient to patient. But most importantly it involve comfort of couple.

In the final decision risk benefit analysis need to be done. Following parameters are taken into account while taking final decision: current medicines, duration of illness, stressors in life, duration of remission, severity of past episodes, history of relapse after drug discontinuation, availability of treatment in case of recurrence and social support system.

Medicine use during pregnancy increases slight risk (2-3 %) of fetal abnormality, which is around 1% without medicines. In many cases couple take this risk, and go for pregnancy on medicine. If you go for pregnancy without medicine then close supervision will be needed.

At-least number of medicine can be reduced in your case. You can ask psychiatrist to stop Depakote and buspin, as they are already being used in very low doses.

You can discus these all issues with your psychiatrist while taking final decision.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
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