Weighing the Risks: the Management of Bipolar Disorder During Pregnancy
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Purpose of Review
The management of bipolar disorder during pregnancy requires difficult treatment decisions be made by both women and their clinicians. There is little consensus on management despite the high prevalence of bipolar disorder in reproductive-aged women. In this review, we have summarized the available literature and discuss the balancing of risks associated with treatment decisions.
Cohort studies have shown a high relapse rate in women with bipolar disorder who discontinue mood-stabilizing medications. The risks of fetal medication exposure have been assessed in multiple database studies.
Management decisions of bipolar disorder in pregnancy have been made difficult by inconsistencies in study outcomes. There were many confounding factors in the studies of medication discontinuation relapse risk. Inconsistencies in the findings of fetal risks from mood-stabilizing medications have further complicated management decisions. Larger studies are needed to clarify the risks of bipolar disorder relapse in pregnancy with and without treatment.
KeywordsPeripartum Antenatal Depression Bipolar disorder Psychopharmacology Pregnancy
Compliance with Ethical Standards
Conflict of Interest
Michael Thomson declares no conflict of interest.
Verinder Sharma reports grants from Assurex, Genome Canada, Neurocrine Biosciences, Sage Therapeutics, Stanley Medical Research Institute and Sunovion Pharmaceuticals outside the submitted work.
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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