Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
I hesitate in answering this questions as "there are no good answers". I am sorry to hear about your daughter's mental illness and concommittant pregnancy. Bipolar disease is clearly a biochemical illlness. The first decison is if terminating the pregnancy is an option which is a terrible choice to have to make and involves morality which is something that cannot in my opinion be appropriately addressed on a website. The greatest problem is that most of the medications used to control mania are tetragenic (causing birth defects), some more than others, but tetragenic none the less. Lithium, haldol and thorazine seem to have the least effect on the fetus, with the anti-convulsants like tegretol the most (from my research). I am going to list a few sites that discuss this issue in more depth. See: www.healthyplace.com/bipolar-disorder/...pregnancy...bipolar-disorder/menu-id-67/ , www.nami.org/Template.cfm?...bipolar_disorder...cfm... , www.everydayhealth.com/bipolar-disorder/pregnancy-and-bipolar-disorder.aspx and lastly , www.womensmentalhealth.org/.../bipolar-disorder-and-pregnancy-should-medications-be-discontinued-2/ . These sites will give more in depth information and thinking points. It would appear that significant consultation needs to occur between the ob/gyn and the psychiatrist (I cannot stress tis enough and you may choose to seek experts in this area), your daughter and since she is a minor yourselves. I have heard of situations where when women who are pregnant and decided to carry to term have been taken off medication and hospitalized until delivery, or at least until later in the pregnancy when the tetragenic effect may be lessened.
Another treatment that has no negative effect on the fetus has been intensive psychotherapy, as it has been shown that a reduction in the amount and degree of emotional stressors has reduced psychotic symptomatology. There is obviously no perfect answer, but there are choices to be made understanding the consequences and accepting the results. Again I do suggest intensive consultation with both a gynecologist and psychiatrist who are experienced and well versed in this type of problem which is clearly a minority of the practitioners.
Please click green "ACCEPT" button on this page if you are satisfied with my answer so that I get credit for my work. Your positive feedback and bonuses are always welcomed. If this is a mental health, or medical emergency, please call emergency services (911 in the USA), or go to your nearest Emergency Room. The opinion provided does not replace an evaluation by an appropriate professional.
I am sorry I could not do more. I again suggest that the providers be experts in this situation and you should feel free to ask. It is a difficult situation, but by no means hopeless. Positive feed back is always appreciated.