Making decisions about medicines when pregnant, planning a pregnancy or breastfeeding is something that people often ask about.
It is important to talkto a healthcare professional about any medication taken in pregnancy. They will give you the information you need to make an informed decision about what is best for both mum and baby. If possible, talk to a doctor before becoming pregnant. If the pregnancy is unplanned, see a doctor as soon as you know.
Most medicines can pass into breast milk. The main questions are “how much” and if this is likely to have an effect on the baby. It is important to remember that being unwell (such as depressed, manic or psychotic) might have a more harmful and lasting effect on mum and baby than a small amount of medicine.
Do not stop your medication suddenly, unless told to by a doctor. Stopping medicines suddenly can be more dangerous than carrying on. After discussion with a doctor, medication might be continued, changed or stopped.
Here we will suggest sources of information that might be of help in understanding medicines used to help in mental health conditions. All of the websites we mention will show you useful, unbiased information to help when making decisions including those about pregnancy and breastfeeding. None is better or worse than the others, but each has its own style that you might find more or less helpful.
The BUMPS website (Best Use of Medicines in Pregnancy) provides specific leaflets about individual medicines and their safety in pregnancy. It is run by the UK Teratology Information Service, a not-for-profit organisation funded by Public Health England.
The Royal College of Psychiatrists
The Royal College of Psychiatrists produces a range of easy-to-read information about different mental health conditions and the available support and treatments. Information is written by doctors in collaboration with patients and carers. The website provides information on mental health in pregnancy including medicines but also on many other related topics.
Choice and Medication
Choice and Medication is a website created by specialist mental health pharmacists that also provides a range of information on mental health conditions and the medicines used to help people to recover and stay well. There are specific leaflets available about medicines in pregnancy. The information on the website about individual medicines includes information about women’s health, pregnancy and breastfeeding.
The Breastfeeding Network
The Breastfeeding Network is a charity set up to support breastfeeding mums and their families. On its website it provides a number of leaflets about medicines in breastfeeding including one on antidepressants. It also provides a telephone helpline and an online chat service to support mums who have questions about breastfeeding.
In recent years, healthcare professionals have become increasingly aware of the dangers of using medicines containing valproate when someone is pregnant. This can have serious effects on the unborn child. Medicines that contain valproate should not be used during pregnancy.
If you are of child-bearing potential and are taking valproate then you and your specialist must discuss this each year and prescribers must be reassured that highly effective contraception is being used to prevent pregnancy. If you are taking a medicine that contains valproate and you want to become pregnant then you should discuss this with your specialist and agree the safest way to proceed.
A booklet has been produced by Medicines & Healthcare products Regulatory Agency with the information that women and girls need to know about valproate.