The perinatal period can increase the risk of mood symptoms recurrence for patients with bipolar disorder, including the risk of depressive episode recurrences and postpartum psychosis. For this reason, the decision regarding pharmacotherapy should be made early-on when bipolar disorder is diagnosed in reproductive age group females. One the other, close to 50% of pregnancies are unplanned so having the risk-benefit knowledge of each mood stabilizer is vital for effective treatment planning during the perinatal period.
Predictors of mood recurrence during pregnancy includes:
- bipolar II disorder diagnosis
- earlier onset
- more recurrences/year
- recent illness
- use of antidepressants
- use of anticonvulsants versus lithium.
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We just updated the following lecture series on the use of mood stabilizers during pregnancy and postpartum for our PEFA members:
This lecture series includes the following clinically relevant topics:
- Preconception Planning: Preparing for Pregnancy.
- Continue or Discontinue Medications during Pregnancy & Postpartum?
- Lithium: During Pregnancy & Postpartum.
- Lithium: use during Lactation.
- Valproate: During Pregnancy & Postpartum.
- Lamotrigine: During Pregnancy & Postpartum.
- Carbamazepine, Gabapentin & Topiramate: During Pregnancy & Postpartum.
- Valproate, Carbamazepine, Lamotrigine, Gabapentin & Topiramate: During Lactation.
- Antipsychotics During Pregnancy & Postpartum.
- Antipsychotics: Rates of Placental Passage.
- Antipsychotics of Choice during Lactation.
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