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Lithium Use and Non-use for Pregnant and Postpartum Women with Bipolar Disorder

  • Bipolar Disorders (R Hirschfeld, Section Editor)
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Abstract

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.

Recent Findings

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.

Summary

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.

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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.

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Hermann, A., Gorun, A. & Benudis, A. Lithium Use and Non-use for Pregnant and Postpartum Women with Bipolar Disorder. Curr Psychiatry Rep 21, 114 (2019). https://doi.org/10.1007/s11920-019-1103-3

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