Lithium Use and Non-use for Pregnant and Postpartum Women with Bipolar Disorder
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Purpose of Review
Despite being recognized as a first-line treatment for bipolar disorder, there is still inconsistent use of lithium in perinatal populations. This article will review data regarding lithium use during the peripartum and provide management recommendations for general psychiatric clinicians.
In contrast to prior data, recent studies indicate that lithium use in pregnancy is associated with either no increased malformations risk or a small increase in risk for cardiac malformations including Ebstein’s anomaly. Limited data also show no significant effect on obstetric or neurodevelopmental outcomes. Data regarding infant lithium exposure via breastmilk remains limited.
Lithium is currently under-prescribed and is an important treatment for women with bipolar disorder in pregnancy and the postpartum. Clinicians must weigh the risk of lithium treatment versus the risk of withholding or changing lithium treatment when managing bipolar disorder in this population.
KeywordsLithium Pregnancy Postpartum Psychosis Bipolar Breastfeeding
Compliance with Ethical Standards
Conflict of Interest
Alyson Gorun and Abigail Benudis each declare no potential conflicts of interest.
Alison Hermann has received personal fees from Sage Therapeutics and a co founder and CMO of Iris OB Health.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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