Weekend brainteaser! (pun intended)

Match the compounds with their generic or brand name!

Since we’ve been trying to get pregnant for the last two months, I’ve been completely off all my medications. My husband, doctor and I decided that it would be better not to marinate the baby in chemicals. It’s an interesting situation to be in. I’m a little living experiment. Most of my friends have been really understanding and non-judgmental about this decision. But honestly, there seems to be an undercurrent of concern. A lot of people (including my OBGYN) have told me that it’s better to have a happy mom than a medication free mom.

I knew I needed to be off lithium because it can cause fetal heart defects although if I have to be on it, they just have to monitor my blood levels carefully. The SSRIs (anti-depressants) really don’t have a long enough track record to be certain, so we’re trying to see if I can do without. If I can’t, I can’t. My doc has said that there are some older, very tried-and-tested anti-psychotics he can give me if I’m really having a hard time.

Here’s my brief history with meds:

Before October 2002:
- Desiprimine (tricyclic) for 18 months as a teenager
- Lots of alcohol

Oct 2002 – Dec 2002:
- Paxil (SSRI)

Jan 2003 – Mar 2003
- Remeron (NaSSA)
- Valium (anti-anxiety)
- Ambien 10mg/day (sleep aid)
- Seroquel 900-200mg/day (anti-psychotic)
- Lithium 900mg/day (mood stabilizer)
- Effexor 300 mg/day (SSRI)

Mar 2003
- Tapered off Remeron & Valium
- Started Wellbutrin 400mg/day (SSRI)

Sept 2004
- Tried unsuccessfully to taper off Lithium

June 2005
- Tapered off Ambien

Nov 2005
- Tried unsuccessfully to taper off Lithium

Jan 2006
- Tapered off Seroquel

Apr 2006
- Tapered off Lithium

May & June 2006
- Tapered off Effexor

July 2006
- Tapered off Wellbutrin

But I wouldn’t be tapering off my meds if my doc and I weren’t already convinced it was time for me to try. That’s the thing with personality disorders… they’re not really treatable with medication. (classic definition: long-lasting, pervasive, rigid and inflexible patterns of thought and behavior that cause serious problems and impairment of functioning.)

With a personality disorder, the patient’s messed-up environment has caused them to cope in ways that only make things worse in the long run. All the meds do is help control moods, anxiety, and thought organization so the patient doesn’t continue to worsen. If the therapy and behavioral training can change the thought and behavior patterns, the patient can address the messed-up environment. Then the moods, anxiety, and thoughts should improve too. Have they? Tune in next time for the continuing saga…

So what do you think? Is it important for pregnancies to be off psych meds or is it better to have a drugged mom with no mood swings?

Answers to the puzzle:
Figure A - Valium or Diazepam
Figure B - Seroquel or Quetiapine
Figure C - Ambien or Zolpidem
Figure D - Remeron or Mirtazapine
Figure E – Norpramin or Desiprimine
Figure F – Wellbutrin or Bupropion
Figure G - Effexor or Venlafaxine
Figure H – Paxil or Paroxetine
Figure I - Eskalith or Lithium
Figure J - Alcohol or Ethanol