• mood stabilizers

    You Asked: Should Lamotrigine (Lamictal) Dose Be Adjusted During Pregnancy?

    For many women with bipolar disorder, lamotrigine (Lamictal) is an effective mood stabilizer.  Given its relatively favorable reproductive safety profile, lamotrigine is a reasonable option for women who require treatment with a mood stabilizer during pregnancy.

    Folic Acid is Essential for All Women of Reproductive Age

    Last week was National Folic Acid Awareness Week at the Centers for Disease Control (CDC), so this seems like a great time to remind women (and their caregivers) of the importance of folic acid in the prevention of birth defects. By taking the recommended dosage of folic acid daily, women will reduce the risk of neural tube defects by 50% - 70%. In addition, women who take folic acid supplements are less likely to give birth to a child with an autism spectrum disorder.

    What’s Worse for Pregnancy: Bipolar Disorder or the Medications Used to Treat It?

    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.

    New Research:  Treatment Decisions by Pregnant Women with Bipolar Disorder 

    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.   However, [...]

    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.

    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.

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