I have taken several Class C drugs during this pregnancy, drugs that by definition should be taken only if the benefit outweighs the potential risks. In each case, I have grilled the prescribing doctor and consulted Dr. Google before tossing back the meds in question, but I've never had a problem filling any prescription until recently.
I am Manic Depressive (bipolar type II).
Although triggers for cyclic change can be widely varied and sometimes unusual or unique, a fairly common one is sleep deprivation. Back in the day, deliberate sleep deprivation was commonly used as a tool to affect cyclic change, and today's psychiatrists are usually quite interested in the sleeping habits of their patients. They call it 'Proper Sleep Hygiene', a phrase I find amusing for no particular reason.
Several months ago, I started having severe sleep problems. Part of it was typical pregnancy discomfort, but a large part was the nightmares I'd been having. They were extremely vivid and disturbing, and I found that after they scared the everloving shit out of me and woke me up at two in the morning, I couldn't get back to sleep.
Recognizing this as a problem, I consulted my doctors. "Hey, how do y'all feel about me taking a Class B antihistamine to ensure that I get enough sleep?" They thought this was a fine idea, and for several months, this is exactly what I did. It is always possible to run into problems with off-label use, and after a while, I noticed that the antihistamines were doing a really excellent job...as antihistamines. They were drying out my nasal passages so much that I started noticing bloody kleenex in the morning. Since I clearly didn't have any blood to spare, I decided to consult my shrink, who said "You're doing it wrong," and prescribed an honest to goodness sleep aid.
I was a little wary of it, because the drug was unfamiliar to me and was also Class C, but after running it by two OBs and a Perinatologist and deciding to take it for the first time while hospitalized (just in case), I decided to bite the bullet and fill the prescription.
That was the idea, anyway.
When my mother went to the pharmacy to pick it up for me, the pharmacist refused to give it to her. "This is Class C," she said, although it's worth noting that this same pharmacist had no such conflicts dispensing Nifedipine (Class C). She called my shrink. The shrink told her to give it to me. She called my OB. My OB said to give it to me. She then called me at home and told me that I should discuss this drug with my obstetrician before taking it.
"I did," I said, probably sounding about as irritated as I was. "I also discussed it with my peri and my shrink, and they all feel that it is in my best interest to take this." She put on a lovely song and dance about drug classifications and risks and benefits and I spoke to her firmly and calmly and she finally relented and agreed to dispense the damned drug.
I feel like I should be awarding her some sort of points for doing her job conscientiously, but somehow I can't. Instead, I look back on all the times that pharmacists have handed me Class C drugs without a care in the world (and sometimes with nary a mention of drug classification) and wonder what is so different about this one. I've taken drugs to breathe, drugs to correct my response to insulin, and drugs to alleviate contractions, and none of those caused a pharmacist to bat even a single eyelash.
This can be looked at in one of two ways: That this pharmacist considered maternal sleep non-essential to the fetus(es) and therefore a frivolous concern on my part, or that because I need a sleep aid to manage a mental illness, I am not considered competant to make these sorts of complicated decisions. I very much wanted to ask the pharmacist which position she was arguing from, but I wanted her to fill the prescription before the pharmacy closed, so I let it go in favor of getting a good night's sleep (or several).
It does still make me wonder, however.
