bipolar disorder - MGH Center for Women's Mental Health

Can We Identify Women at High Risk for Postpartum Psychosis?

Postpartum psychosis occurs in about 1 to 2 per 1000 women after delivery. While there appears to be a strong link between postpartum psychosis and bipolar disorder, it is estimated that about half of women who present with postpartum psychosis have no psychiatric history prior to delivery, making it difficult to identify those women who are at greatest risk for this illness. A recent study, using data from the Swedish Medical Birth Registry, has examined possible risk factors that may be used to identify women at risk for postpartum psychosis.

By Ruta Nonacs, MD PhD|2025-09-03T16:46:41-04:00August 3rd, 2009|Postpartum Psychiatric Disorders, Postpartum Psychosis, Prevention|Comments Off

Mental Health Parity in Massachusetts

Recent changes expanded the scope of mental health parity in the Commonwealth of Massachusetts, which requires insurance companies to cover specified diagnoses on a “nondiscriminatory basis”. This means that copayments, deductibles, coinsurance, unit of service limits- such as hospital days and outpatient visits, and/or annual or lifetime maximums are no greater for mental disorders when compared to physical conditions.

By MGH Center for Women's Mental Health|2015-08-12T14:51:49-04:00July 16th, 2009|Advocacy, General|Comments Off

Pregnancy May Lower Lamotrigine (Lamictal) Blood Levels

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.

By Ruta Nonacs, MD PhD|2025-06-26T09:07:13-04:00May 5th, 2009|Anti-Epileptic Drugs, Bipolar Disorder, Mood Stabilizers, Pregnancy & Medications|Comments Off

Case: Prevention of Mood Episodes When Planning for Pregnancy

Our Perinatal and Reproductive Psychiatry team often discusses clinical cases in Rounds, a confidential forum in which we can get advice and consultation from peers who also work in the area of Women's Mental Health. We discussed a patient's situation recently that highlighted the controversial area about how to prevent mood episodes in a woman planning for pregnancy.

By MGH Center for Women's Mental Health|2015-08-12T14:05:35-04:00March 2nd, 2009|Depressive Disorders, Prevention, Psychiatric Disorders During Pregnancy|Comments Off

Bipolar Disorder and PMS

Premenstrual worsening of mood is common among women with depression, but little is known about how often women with bipolar disorder experience worsening of their mood premenstrually. In a study by Payne et al. (2007), premenstrual symptoms were reported by twice as many women diagnosed with mood disorders (mixture of Bipolar Disorder and Major Depressive Disorder) than by women who did not have a psychiatric diagnosis (67.7% vs. 33.7%). These results suggest that PMS symptoms are particularly common in women with bipolar disorder and major depressive disorder. However, this study involved women reporting prior experiences with PMS, which is not always as accurate as studies that involve prospective monitoring to obtain real-time reporting of PMS symptoms. Such prospective studies of PMS in women with bipolar disorder are sparse and have inconsistent conclusions.

By MGH Center for Women's Mental Health|2016-03-28T13:38:38-04:00December 15th, 2008|Bipolar Disorder, Diagnosis & Screening, PMS & PMDD, Prevalence & Risk Factors|Comments Off

Dr. Lee Cohen talks with Dr. Oz about Pregnancy and Mood Disorders on Oprah.com

Earlier this year, Dr. Lee S. Cohen, Director of the MGH Center for Women's Mental Health, spoke with Dr. Mehmet Oz from Oprah.com and a woman with bipolar disorder about mood disorders during pregnancy and weighing the risks of treatment options.

By MGH Center for Women's Mental Health|2015-08-12T12:15:34-04:00December 8th, 2008|Bipolar Disorder, Depressive Disorders, Psychiatric Disorders During Pregnancy|Comments Off

Oral Contraceptives Reduce Lamotrigine (Lamictal) Blood Levels

Lamotrigine (Lamictal) has been effectively used for the maintenance treatment of bipolar disorder. Many women suffering from bipolar disorder are of childbearing age; therefore an adequate contraception is a major concern that needs to be addressed in this population.

By Ruta Nonacs, MD PhD|2025-06-26T09:07:14-04:00October 20th, 2008|Anti-Epileptic Drugs, General, Hormone Therapy|Comments Off

New England Journal of Medicine Case Report: Postpartum Psychosis in a Woman with Bipolar Disorder

The most recent issue of the New England Journal of Medicine includes the presentation of a case from the Center for Women's Mental Health of a woman with bipolar disorder who developed postpartum psychosis after the birth of her child. The case highlights some of the clinical challenges in treating patients with bipolar disorder during pregnancy and the postpartum period and reviews the current literature on postpartum psychosis.

By MGH Center for Women's Mental Health|2016-03-28T13:23:59-04:00August 11th, 2008|Bipolar Disorder, Diagnosis & Screening, Postpartum Psychiatric Disorders, Postpartum Psychosis, Prevalence & Risk Factors|Comments Off

Bipolar Disorder and Pregnancy: Should Medications Be Discontinued?

As many of the traditional mood stabilizers used to treat bipolar disorder, including lithium and valproic acid, carry some teratogenic risk and the reproductive safety of other medications, including the atypical antipsychotic agents, has not been well-characterized, many women with bipolar disorder decide to discontinue their treatment during pregnancy. A new study from Dr. Adele Viguera and her colleagues at the Massachusetts General Hospital and the Emory University School of Medicine helps to better define the risks associated with discontinuing treatment during pregnancy.

By MGH Center for Women's Mental Health|2016-03-28T13:38:38-04:00March 7th, 2008|Anti-Epileptic Drugs, Bipolar Disorder, Child Outcomes, Mood Stabilizers, Outcomes, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Risk of Malformations|Comments Off

Polycystic Ovarian Syndrome in Women Taking Valproate

Polycystic ovarian syndrome (PCOS) occurs in 4-7% of women and is characterized by irregular menstrual cycles and hyperandrogenism (facial hair, acne, male-pattern hair loss, acne, or elevated male hormone levels). The majority of women with PCOS also suffer from obesity and insulin resistance. PCOS has been associated with a spectrum of health problems including infertility, diabetes, and possibly heart disease and endometrial cancer. Recently there has been concern that women with bipolar disorder who are treated with the mood stabilizer valproate (VPA; brand name Depakote or Depakene), may be at higher risk for PCOS, although the data have been somewhat conflicting.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:24-04:00November 8th, 2007|General, PCOS|Comments Off