Format

Send to

Choose Destination
Expert Rev Neurother. 2020 Mar 19:1-11. doi: 10.1080/14737175.2020.1743684. [Epub ahead of print]

Managing bipolar disorder during pregnancy and the postpartum period: a critical review of current practice.

Author information

1
Departments of Psychiatry and Obstetrics & Gynecology, University of Western Ontario, London, Canada.
2
Parkwood Institute Mental Health, London, Canada.
3
Department of Psychiatry, Schulich School of Medicine and Dentistry, London, Canada.
4
Department of Obstetrics & Gynecology, McMaster University, Hamilton, Canada.

Abstract

Introduction: Despite increased interest in the pharmacotherapy of bipolar disorder during pregnancy and the postpartum period, management of the disorder during these critical periods in a woman's life remains challenging.Areas covered: The authors review the effect of pregnancy and the postpartum period on the course of bipolar disorder, describe adverse pregnancy and birth outcomes, and discuss the pharmacotherapy of bipolar disorder during and after pregnancy.Expert opinion: When treating women with bipolar disorder of childbearing age, clinicians should consider the possibility of pregnancy. Pre-conception counseling should be an integral part of the overall plan to manage bipolar disorder during and after pregnancy. Peripartum management of bipolar disorder is challenging and requires balancing of risks associated with the use of drugs and the potentially deleterious effects of untreated bipolar disorder on the fetus/child. Formulation of personalized treatment requires knowledge of both current (episode type, symptom severity, psychiatric comorbidity, and safety concerns) and historical (episode frequency, response to drugs and psychotherapy, and the effect of reproductive events including pregnancy and postpartum period) factors. Close monitoring is essential for early detection and management of mood episodes. Routine safety assessments are necessary to identify women at risk of harming themselves or the newborn.

KEYWORDS:

Antidepressants; antipsychotics; bipolar disorder; breastfeeding; depression; lithium; mood stabilizers; postpartum; pregnancy; safety

Supplemental Content

Full text links

Icon for Taylor & Francis
Loading ...
Support Center