Mood Stabilizers During Lactation
Bipolar disorder usually starts at a very early age, and due to this females suffering from this disorder are at risk of an episode throughout their reproductive life. Data also suggest the association of relapse and recurrence of episodes in females with bipolar disorder, during pregnancy and postpartum. Some of the postpartum-onset psychiatric syndromes also are known to turn out to be bipolar disorder in the long run. Due to all these factors, on many occasions, females with bipolar disorder have to be continued on mood stabilizers during pregnancy and lactation. Data on the safety of use of mood stabilizers during pregnancy and lactation is very limited and is of poor quality. Most of the data is available in the form of case reports, small case series or small sample open-label studies. Hence, clinicians are often faced with a situation, where they have to weigh the pros and cons of prescribing mood stabilizers during lactation. Further, clinicians are often faced with a situation whether to recommend breastfeeding for a neonate, whose mother is taking mood stabilizers. Considering the benefits of breastfeeding for both mother and the neonate, it can be suggested that, wherever feasible, breastfeeding must be continued. Available data suggest that compared to other mood stabilizers, valproate is a better option. If the mother is allowed to breastfeed while taking mood stabilizers, then certain physiological aspects of the newborn’s sleep must be taken into account. Medications can be taken after feeding the baby, just before the newborn’s longest sleep duration.
KeywordsBipolar disorder Mood stabilizers Breastfeeding Lactation
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