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Can J Psychiatry. 2002 Jun;47(5):426-36.

Managing bipolar disorder during pregnancy: weighing the risks and benefits.

Author information

  • 1Perinatal and Reproductive Psychiatry Program, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. aviguera@partners.org

Abstract

BACKGROUND:

Challenges for the clinical management of bipolar disorder (BD) during pregnancy are multiple and complex and include competing risks to mother and offspring.

METHOD:

We reviewed recent research findings on the course of BD during pregnancy and postpartum, as well as reproductive safety data on the major mood stabilizers.

RESULTS:

Pregnancy, and especially the postpartum period, are associated with a high risk for recurrence of BD. This risk appears to be limited by mood-stabilizing treatments and markedly increased by the abrupt discontinuation of such treatments. However, drugs used to treat or protect against recurrences of BD vary markedly in teratogenic potential: there are low risks with typical neuroleptics, moderate risks with lithium, higher risks with older anticonvulsants such as valproic acid and carbamazepine, and virtually unknown risks with other newer-generation anticonvulsants and atypical antipsychotics (ATPs).

CONCLUSIONS:

Clinical management of BD through pregnancy and postpartum calls for balanced assessments of maternal and fetal risks and benefits.

PMID:
12085677
[PubMed - indexed for MEDLINE]
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