[Bipolar disorder, pregnancy and the postpartum--risks and possibilities of pharmacotherapy].
Pregnancy and the postpartum are times of increased risk for women with bipolar disorder to develop mood episodes, especially depressions that may require pharmacotherapy. If mood stabilizing agents are discontinued prior or due to pregnancy, the risk for relapse increases dramatically. On the other hand, there is no psychotropic drug that is completely risk-free for the unborn. Some mood stabilizing medications are teratogenic, others can cause severe perinatal complications. Thus, the decision whether to treat the pregnant women with psychotropic drugs is difficult to make. In this paper, the reproductive risks of mood stabilizing agents, antidepressants, neuroleptics and benzodiazepines for the fetus are reviewed. During the postpartum period severe mood disorders can occur. The signs and symptoms of these disorders are reviewed and therapeutic strategies are discussed.
Krüger
Stephanie
S
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité Campus Mitte, Universitätsmedizin Berlin, Berlin. stephanie.krueger@charite.de
D000014:Abnormalities, Drug-Induced / Q000209:etiology / Q000517:prevention & control; D000927:Anticonvulsants / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D001942:Breast Feeding; D019052:Depression, Postpartum / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D011644:Puerperal Disorders / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D012307:Risk Factors; D055502:Secondary Prevention
D000927:Anticonvulsants; D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents