Women with bipolar disorder are at significant risk for recurrent illness during the postpartum period. Â After miscarriage, an event which is associated with both hormonal changes and psychological complexity, is the risk for recurrent illness [...]
Women with bipolar disorder (BD) are at extremely high risk for postpartum psychiatric illness, specifically postpartum psychosis. Â While the American College of Obstetrics and Gynecology now recommends that all women be screened for depression during [...]
Women with bipolar disorder often experience fluctuating mood symptoms across the menstrual cycle, typically reporting an exacerbation of symptoms during the premenstrual phase of the cycle (Rasgon et al, 2003, 2005). Â Other studies have indicated [...]
The American College of Obstetrics and Gynecology now recommends that women be screened for depression during pregnancy. Â Because depressive symptoms during pregnancy have been associated with worse outcomes and are a robust predictor of postpartum [...]
Women with histories of major depression are vulnerable during the transition to menopause and are at increased risk for relapse; however, we have less information on how this transition affects women with bipolar disorder.
In studies of pregnant women with unipolar depression, it has been shown that untreated psychiatric illness in the mother may have a negative impact on pregnancy outcomes, influencing the length of gestation and birthweight. There is far less data on pregnancy outcomes in women with bipolar disorder. A recent Swedish study analyzes pregnancy outcomes in treated and untreated women with bipolar disorder and attempts to distinguish between the effects of medication versus the effects of untreated psychiatric illness in the mother.
Choosing whether to maintain or discontinue mood stabilizer treatment during pregnancy requires weighing the risks of teratogenic outcomes associated with exposure to a particular drug against the risks of recurrence of untreated affective illness. Â Â However, [...]
Women with bipolar disorder are at increased risk for recurrence of illness during pregnancy. Therefore, many women with bipolar disorder elect to continue treatment with medications during pregnancy after weighing the risks and benefits of various treatment options with their physicians. Lamotrigine (Lamictal) is an anticonvulsant used to treat bipolar disorder. While the safety data on this relatively new anticonvulsant in pregnancy is limited, pregnancy registry data suggests that lamotrigine may pose less of a risk to the developing fetus than with older anticonvulsants, such as valproate (Depakote). With lamotrigine emerging as an effective and relatively safe treatment for pregnant women with bipolar disorder, more attention is now being paid to the effects of pregnancy on lamotrigine levels.
There have long been concerns regarding the use of the anticonvulsant valproate (Depakote) during pregnancy. First trimester use of valproate has been associated with a 3-5% risk of neural tube defects, as well as an increased risk of other malformations affecting the heart, limbs, and genitals. A recent report published in the New England Journal of Medicine indicates that in utero exposure to valproate may also result in lower IQ.   Â
As more research is conducted within the field of women's mental health, there are times when recommendations may change depending on the available data.  We will discuss a case here to illustrate this point.
