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khagihara, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 6590
Experience:  Trained in OB & GYN for many years.
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I just recently found out i am pregnant. my first ob appt is

Customer Question

i just recently found out i am pregnant. my first ob appt is next friday. i have concerns about some of the medication i am on 1st being a mental health med called LAMOTRIGINE 100mg twice daily..i was told to discontinue this medication cold turkey. i
was also told that by coming off this med cold turkey could do harm to me and my baby..but staying on it could harm it also. I also have hyperthroidism and take the medication PROPYLTHIOURACIL 50mg twice daily. i found out today from a pharmisit that this
is a class D med that can do more harm to my baby. i have a history a seisuzes and am also on LINSINOPRIL 10mg once daily. and BUPROPION 150mg twice daily. my question to you is should i stop taking the meds cold turkey and if i do what could be the side effects
by staying on or going off of them. because i do worry about my mental state as well for the well being of my child any information or opinion would be wonderful. thank you very much Erica sorry this is my 8th child. and i've had seizures twice on 2 different
Submitted: 2 years ago.
Category: OB GYN
Expert:  khagihara replied 2 years ago.
You should continue to take LAMOTRIGINE. An overall increase in major congenital malformations has not been observed in available studies; however, an increased risk for cleft lip or cleft palate has not been ruled out. An increased risk of malformations following maternal lamotrigine use may be associated with larger doses (over 400 mg a day).
You may continue to take Propylthiouracil. Teratogenic effects have not been observed; however, nonteratogenic adverse effects, including fetal and neonatal hypothyroidism, goiter, and hyperthyroidism, have been reported following maternal propylthiouracil use. Uncontrolled maternal hyperthyroidism may result in adverse neonatal outcomes (eg, prematurity, low birth weight) and adverse maternal outcomes (eg, pre-eclampsia, congestive heart failure, stillbirth, and abortion). To prevent adverse fetal and maternal events, normal maternal thyroid function should be maintained prior to conception and throughout pregnancy. Antithyroid treatment is recommended for the control of hyperthyroidism during pregnancy. Propylthiouracil is considered first-line therapy, especially during the first trimester. Due to an increased risk of liver toxicity, use of methimazole may be preferred during the second and third trimesters.
You should not take LISINOPRIL. It is associated with oligohydramnios. Oligohydramnios, due to decreased fetal renal function, may lead to fetal lung hypoplasia and skeletal malformations. Its use in pregnancy is also associated with anuria, hypotension, renal failure, skull hypoplasia, and death in the fetus/neonate. We suggest therapy with either methyldopa or labetalol. A long-acting calcium channel blocker (eg, nifedipine) can be added if needed.
You may take bupropion. An increased risk of congenital malformations has not been observed following maternal use of bupropion during pregnancy; however, data specific to cardiovascular malformations is inconsistent. The long-term effects on development and behavior have not been studied.