title: Women are not the same as men: specific clinical issues for female patients with bipolar disorder.
abstract: Women are not the same as men. While this observation can be considered to subjectively manifest in many different ways, objectively a greater tendency for bipolar II disorder, depressive symptoms, a rapid cycling course, and the consequences of being of child-rearing age can all represent additional challenges for female patients. Despite much recent interest in improving the management of patients with bipolar disorder, relatively little guidance exists relating to female-biased gender-specific issues. This review article will explore how female gender can influence bipolar disorder and its treatment and will focus on epidemiologic differences, the relevance to clinical presentation of events unique to women (particularly contraception, pregnancy, and lactation), and the importance of considering gender when making decisions about the pharmacological management of mood. All female patients should receive counseling regarding family planning and sexually transmitted diseases, as well as the risks of and treatment options during pregnancy and postpartum. Wherever possible, treatment choices should be made in a partnership between patient and clinician.
authors.affiliation: Institute of Psychiatry and Maudsley Hospital, De Crespigny Park, London, UK. v.curtis@iop.kcl.ac.uk
authors.forename: Vivienne
authors.initials: V
authors.lastname: Curtis
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000009:adverse effects; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology*; D003376:Counseling; D003987:Dibenzothiazepines / Q000009:adverse effects; D005193:Family Planning Services; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D016651:Lithium Carbonate / Q000009:adverse effects; D008297:Male; D000077152:Olanzapine; D011247:Pregnancy; D011248:Pregnancy Complications; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000009:adverse effects; D013723:Teratogens; D014227:Triazines / Q000009:adverse effects; D014635:Valproic Acid / Q000009:adverse effects; D016387:Women's Health
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D003987:Dibenzothiazepines; D013723:Teratogens; D014227:Triazines; D001569:Benzodiazepines; D016651:Lithium Carbonate; D000069348:Quetiapine Fumarate; D014635:Valproic Acid; D018967:Risperidone; D000077152:Olanzapine; D000077213:Lamotrigine