title: Lithium prescribing during pregnancy: a UK primary care database study.
abstract: BACKGROUND
  Women taking lithium must decide whether to continue the medication if they conceive or plan to conceive. Little is known about the extent of prescribing of lithium during pregnancy.
  
  
  OBJECTIVE
  To determine: 1) the prevalence of lithium prescribing during pregnancy and 2) to assess whether pregnancy is associated with discontinuation of lithium.
  
  
  METHODS
  First, we identified women receiving any lithium prescriptions before and during pregnancy using The Health Improvement Network (THIN) primary care database. Subsequently, we used a Kaplan-Meier plot to compare time to last prescription in women prescribed lithium continuously three months before pregnancy and a comparison group of non-pregnant women. Finally, we described the characteristics of the women prescribed lithium in pregnancy.
  
  
  RESULTS
  Very few women were prescribed lithium during pregnancy; out of 458,761 pregnancies, we identified 47 (0.01%) in which lithium was prescribed after the 6th week of pregnancy (when the pregnancy was likely to be known). In our study of discontinuation, we found pregnant women were more likely to stop lithium than those who were not pregnant. Of the 52 women who were being continuously prescribed lithium three months before pregnancy, only 17 (33%) continued receiving prescriptions beyond the 6th week of pregnancy. However, most of these 17 women continued treatment throughout pregnancy.
  
  
  CONCLUSIONS
  Pregnancy was strongly associated with discontinuation of lithium. Further evidence on the risks of lithium is needed so that women can weight these against the risk of a deterioration in maternal mental health.
authors: University College London, Department of Primary Care and Population Health, London, United Kingdom.
authors: Rachel L
authors: RL
authors: McCrea
authors: University College London, Department of Primary Care and Population Health, London, United Kingdom.
authors: Irwin
authors: I
authors: Nazareth
authors: London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors: Stephen J W
authors: SJ
authors: Evans
authors: University College London, Division of Psychiatry, London, United Kingdom.
authors: David P J
authors: DP
authors: Osborn
authors: The McPin Foundation, London, United Kingdom.
authors: Vanessa
authors: V
authors: Pinfold
authors: University of Oxford, University Department of Psychiatry, Oxford, United Kingdom.
authors: Phil J
authors: PJ
authors: Cowen
authors: University College London, Department of Primary Care and Population Health, London, United Kingdom.
authors: Irene
authors: I
authors: Petersen
mesh_terms: D019992:Databases as Topic; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011320:Primary Health Care; D006113:United Kingdom; D028761:Withholding Treatment
chemical_list: D008094:Lithium