Dr. Lee S. Cohen, Director of the Ammon-Pinizzotto Center for Women's Mental Health at Massachusetts General Hospital, recently shared his insights on the long-term behavioral follow-up of children exposed to mood stabilizers and antidepressants with Ob.Gyn News on August 16,
A recent review and meta-analysis found that upwards of 20% of women with no history of psychiatric illness experience their first bipolar-spectrum mood episode during the perinatal period.
While data are limited regarding AEDs and breastfeeding, it appears that none of the AEDs are excreted at high levels into the breast milk, nor have they been associated with high rates of adverse events in the nursing infant.
Second-generation antipsychotic medications associated with high metabolic risk (quetiapine, olanzapine, and clozapine) were associated with increased risk of gestational diabetes; other antipsychotics were not.
Prenatal exposure to antipsychotic medications was not associated with increased risk of neurodevelopmental disorders in offspring.
The most recent publication from the National Pregnancy Registry focuses on overall risk of malformations associated with the class of antipsychotic medications.
Because women with bipolar disorder are at high risk for relapse during the postpartum period, we typically recommend that women continue treatment with lithium throughout the postpartum period. While this intervention clearly decreases risk for postpartum psychiatric illness, the use of lithium while breastfeeding presents certain challenges.
Women with bipolar disorder (BD) are at extremely high risk for postpartum psychiatric illness, including postpartum psychosis. While the American College of Obstetrics and Gynecology now recommends that all women be screened for depression [...]
For many women with bipolar disorder, lamotrigine (Lamictal) is an effective mood stabilizer. Given its favorable reproductive safety profile, lamotrigine is a reasonable option for women who require treatment with a mood stabilizer during pregnancy. [...]
Polycystic Ovarian Syndrome (PCOS) is the most common endocrine-related dysfunction in women of reproductive age. Multiple studies have observed a higher prevalence of psychiatric illness, including depressive disorders, anxiety disorders, and bipolar disorder in [...]
