title: Lamotrigine in bipolar disorder: efficacy during pregnancy.
abstract: OBJECTIVE
  Clinical management of bipolar disorder (BPD) patients during pregnancy is a major challenge. The high risk of bipolar depression during pregnancy encourages consideration of lamotrigine (LTG). We therefore compared recurrence risks among pregnant women with BPD treated with LTG to those discontinuing mood stabilizer therapies.
  
  
  METHODS
  We compared risks and weeks to new DSM-IV illness-episodes among 26 initially clinically stable pregnant women diagnosed with DSM-IV BPD who continued LTG treatment to those discontinuing all mood stabilizer treatment during pregnancy.
  
  
  RESULTS
  The risk of new illness-episodes with LTG was 30% versus 100% after discontinuing mood stabilizers, and survival-computed time-to-25%-recurrence was 28.0 versus 2.0 weeks (chi(2 )=17.3, p < 0.0001; hazard ratio = 12.1; 95% confidence interval = 1.6-91.7).
  
  
  CONCLUSIONS
  Discontinuing mood stabilizer treatment presents high risks of illness-recurrence among pregnant women diagnosed with BPD. LTG may afford protective effects in pregnancy, and its reported fetal safety compares favorably to other agents used to manage BPD.
authors.affiliation: Department of Psychiatry, Emory University School of Medicine, Atlanta, GA 30322, USA. jeff.newport@emory.edu
authors.forename: D Jeffrey
authors.initials: DJ
authors.lastname: Newport
authors.forename: Zachary N
authors.initials: ZN
authors.lastname: Stowe
authors.forename: Adele C
authors.initials: AC
authors.lastname: Viguera
authors.forename: Martha R
authors.initials: MR
authors.lastname: Calamaras
authors.forename: Sandra
authors.initials: S
authors.lastname: Juric
authors.forename: Bettina
authors.initials: B
authors.lastname: Knight
authors.forename: Page B
authors.initials: PB
authors.lastname: Pennell
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Baldessarini
mesh_terms: D000328:Adult; D018692:Antimanic Agents / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000188:drug therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced* / Q000453:epidemiology; D037841:Pregnant People; D012306:Risk; D013375:Substance Withdrawal Syndrome; D016019:Survival Analysis; D014227:Triazines / Q000009:adverse effects*
chemical_list: D018692:Antimanic Agents; D014227:Triazines; D000077213:Lamotrigine