When’s the best time to see a perinatal psychiatrist?
The best time to see a perinatal psychiatrist is sooner than you might expect. Women with a history of depression or anxiety should ideally see a perinatal psychiatrist at least a year before they think they’d like to become pregnant. During this year, the woman can prepare to become pregnant.
If a woman’s mood is currently “euthymic” (good), this may mean that she can slowly the number and dosages of the psychiatric medications she is taking. If she does not require a medication in order to feel well, it is better to not expose a developing fetus to the medication.
On the other hand, she is not feeling well, this is the time to figure out which medications will help her. It is better to figure this out before pregnancy. If this is not known before pregnancy, we may have to expose the baby to multiple medications in order to get the woman feeling well.
Once medications have been properly adjusted, I generally recommend a woman to wait to become pregnant for at least 6 months to ensure that she is stable on the new regimen.
Of course, no two women’s situation are exactly the same. If a woman is very young, and fertility is unlikely to be an issue should she wait a little longer, I may recommend she wait a whole year before becoming pregnant. If a woman is close to an age when conception is likely to become more difficult the longer she waits, I may recommend a shorter period.