Mood stabilizers in pregnancy and lactation

Indian Journal of Psychiatry
Sandeep Grover, Ajit Avasthi

Abstract

Management of bipolar during pregnancy and postpartum is very challenging. The treating clinicians have to take into account various factors like current mental state, longitudinal history of the patient, past history of relapse while off medication, response to medication, time of pregnancy at which patient presents to the clinician, etc. The choice of drug should depend on the balance between safety and efficacy profile. Whenever patient is on psychotropic medication, close and intensive monitoring should be done. Among the various mood stabilizers, use of lithium during the second and third trimester appears to be safe. Use of valproate during first trimester is associated with major malformation and long-term sequalae in the form of developmental delay, lower intelligence quotient, and higher risk of development of autism spectrum disorder. Similarly use of carbamazepine in first trimester is associated with higher risk of major congenital malformation and its use in first trimester is contraindicated. Data for lamotrigine (LTG) appears to be more favorable than other antiepileptics. During lactation, use of valproate and LTG is reported to be safe. Use of typical and/atypical antipsychotic is a good option during pregnancy...Continue Reading

References

Mar 1, 1991·The British Journal of Psychiatry : the Journal of Mental Science·D E StewartA M van Hulst
Mar 7, 1991·The New England Journal of Medicine·F W Rosa
Jun 22, 1989·The New England Journal of Medicine·K L JonesJ Adams
May 1, 1987·The British Journal of Psychiatry : the Journal of Mental Science·R E KendellC Platz
Apr 21, 1973·British Medical Journal·M SchouA Villeneuve
Nov 30, 1967·The New England Journal of Medicine·N Newton, M Newton
Oct 1, 1972·The Journal of Pediatrics·W W Tunnessen, C G Hertz
Jun 1, 1983·Clinical Obstetrics and Gynecology·J F Cordero, G P Oakley
Jul 1, 1984·Acta paediatrica Scandinavica·I Felding, A Rane
Apr 26, 1984·The New England Journal of Medicine·S S Entman, W K Vaughn
Nov 1, 1995·The American Journal of Psychiatry·L S CohenJ F Rosenbaum
Jan 12, 1994·JAMA : the Journal of the American Medical Association·L S CohenM L Weiner
Jun 1, 1994·The American Journal of Psychiatry·C BarnasW W Fleischhacker
Sep 1, 1993·Archives of Disease in Childhood·E Thisted, F Ebbesen
Jun 1, 1996·The Psychiatric Clinics of North America·G S Sachs
Jan 1, 1997·European Journal of Clinical Pharmacology·B RambeckU Jürgens
Aug 1, 1997·The Journal of Clinical Psychiatry·S C StonerJ Vaughn
Apr 29, 1998·Journal of Clinical Psychopharmacology·K L Wisner, J M Perel
Aug 1, 1997·Epilepsia·F J MackayR D Mann
May 14, 1998·Epilepsia·T TomsonS Vitols
Jun 19, 1998·The Journal of Clinical Psychiatry·R W Baker, K N Chengappa
Jul 8, 1998·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·C L Bowden
Aug 26, 1998·Psychiatric Services : a Journal of the American Psychiatric Association·R A Dickson, L Hogg
Nov 26, 1998·The British Journal of Psychiatry : the Journal of Mental Science·I M Terp, P B Mortensen
May 29, 1999·Journal of Chromatography. B, Biomedical Sciences and Applications·S C KasperC O Garner
Feb 15, 2000·The American Journal of Psychiatry·A C VigueraR J Baldessarini
Mar 25, 2000·The Journal of Clinical Psychiatry·L H Chaudron, J W Jefferson
Apr 13, 2000·Pharmacopsychiatry·J KirchheinerD Bolk-Weischedel
May 19, 2000·The Journal of Clinical Psychiatry·C M PiontekK L Wisner
May 29, 2000·Clinical Dysmorphology·M Tekin, J Ellison
Jul 27, 2000·The American Journal of Psychiatry·K H LittrellN Hilligoss
Aug 5, 2000·Journal of Clinical Psychopharmacology·D J GoldsteinM C Fung
Apr 12, 2001·The New England Journal of Medicine·L B HolmesL M Ryan
Jun 30, 2001·The American Journal of Psychiatry·V K BurtE Muntean
Jan 5, 2002·Psychiatric Services : a Journal of the American Psychiatric Association·Mohammad Masud IqbalThad Ryals
Feb 13, 2002·The Journal of Clinical Psychiatry·T Ratnayake, Susan E Libretto
Mar 5, 2002·The Journal of Clinical Psychiatry·Terence A Ketter, Joseph R Calabrese
Apr 12, 2002·Teratology·T H ShepardJ E Polifka
May 7, 2002·The Australian and New Zealand Journal of Psychiatry·L M Lim
May 15, 2002·The Journal of Clinical Psychiatry·Marlene P FreemanPaul E Keck
Jul 11, 2002·Pharmacopsychiatry·D N MendhekarR C Jiloha
Aug 15, 2002·Pharmacology, Biochemistry, and Behavior·Helen Rosengarten, David Quartermain
Nov 26, 2002·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Y YogevB Kaplan

❮ Previous
Next ❯

Citations

Jun 3, 2018·BMC Pregnancy and Childbirth·Alastair Macfarlane, Trisha Greenhalgh
Feb 22, 2017·Indian Journal of Psychiatry·Nilesh ShahG Prasad Rao
Sep 27, 2018·Clinical Pharmacokinetics·Michael PaulzenGeorgios Schoretsanitis
Mar 4, 2021·Current Opinion in Psychiatry·Paola Dazzan

❮ Previous
Next ❯

Methods Mentioned

BETA
cesarean section
sedation

Related Concepts

Related Feeds

Bipolar Disorder

Bipolar disorder is characterized by manic and/or depressive episodes and associated with uncommon shifts in mood, activity levels, and energy. Discover the latest research this illness here.

Antipsychotic Drugs

Antipsychotic drugs are a class of medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia and bipolar disorder. Discover the latest research on antipsychotic drugs here

Autism

Autism spectrum disorder is associated with challenges with social skills, repetitive behaviors, and often accompanied by sensory sensitivities and medical issues. Here is the latest research on autism.

Related Papers

Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
U F Malt, T Fladvad
Psychiatria polska
Giulia CostoloniAndrea Fagiolini
© 2021 Meta ULC. All rights reserved