[Treatment of bipolar disorder during pregnancy and in the postpartum period].
BACKGROUND
Pharmacological treatment and prophylaxis of bipolar disorders during pregnancy and in the postpartum period imply complicated clinical assessments.


METHODS
This article is based on a non-systematic search in PubMed and the authors' clinical experience.


RESULTS
If a woman is already using a prophylactic drug at the time of pregnancy, she can in general continue to do so during pregnancy, with the exception of valproate. If the disorder starts during pregnancy; lithium, lamotrigine or second generation antipsychotic drugs are suitable alternatives. In general, drugs used during pregnancy can also be used in the postpartum period, although some require special precautions if the mother wishes to breast-feed. If treatment is initiated after delivery, the mother's wish to breast-feed should be taken into consideration when choosing a drug.


CONCLUSIONS
Although existing studies have weaknesses, there is sufficient evidence to give qualified advice regarding choice of medication for bipolar disorder during pregnancy and in the postpartum period.
Forskningsenheten, Psykiatrisk divisjon, Helse Bergen HF, Postboks 23 Sandviken, 5812 Bergen, Norway. jaob@helse-bergen.no
Jan Øystein
JØ
Berle
Dag Kristen
DK
Solberg
Olav
O
Spigset
D018692:Antimanic Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D000075202:Contraindications; D005260:Female; D006801:Humans; D007774:Lactation / Q000187:drug effects; D000077213:Lamotrigine; D018020:Lithium Compounds / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D011644:Puerperal Disorders / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D012307:Risk Factors; D014227:Triazines / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
D018692:Antimanic Agents; D014150:Antipsychotic Agents; D018020:Lithium Compounds; D014227:Triazines; D014635:Valproic Acid; D000077213:Lamotrigine