We often discuss the potential risks to a fetus when the mother is taking psychiatric medications, but we rarely if ever consider the potential risks of a prospective father taking psychiatric medications. One of our readers posted a question addressing this issue.
Hi there, my husband started taking Depakote for bipolar disorder several months ago. We are talking about having another baby and are wondering whether it’s safe for us to conceive while he is on Depakote? Any advice is helpful, thanks.
Dr. Fink answers…
There are no clear answers to this question in the medical literature, but there is an increasing body of evidence to suggest that paternal exposures can affect fetal genetics and development. There is fairly clear and convincing data to show that certain types of radiation exposures in fathers can cause specific genetic changes and risks of certain diseases in their children. Similarly, the data are increasingly strong around certain toxic environmental exposures to fathers, such as pesticides, that may cause genetic changes that affect the developing baby. Some medications and compounds have been looked at as well, but we don’t have many specific answers about particular medications.
We know now that genetic transmission from parents to children is not as simple as we once thought. Epigenetics is becoming increasingly important in the study of human development. It means that stimuli of all kinds – internal and external – can actually chemically alter our genes, and those alterations can have powerful influences on the development of the next generation. So both parents are not just giving their genes, but they are giving the effects of life experience that have acted on those genes.
What that means is that paternal exposures are likely to have some effects – but the specifics of those effects are not known yet. It is a different model than before when we thought only maternal exposures mattered. Caution and conversation with trusted medical professionals are the best way to approach this type of situation.
Of course, deciding to have children is a highly personal decision for anyone. All prospective parents – with or without bipolar disorder or other illnesses – will want to think carefully about environmental exposures that could possibly affect developing humans.
In this piece, we are noting that we need to expand the notion of environmental exposure beyond the mother, to include things that the father is exposed to. That doesn’t preclude having children at all; it is always about trying to make the most informed decisions that are right for any particular individual. No one can answer these questions for someone else.