Managing Bipolar Disorder in Childbearing Women

Course overview

Bipolar disorder is a common and serious psychiatric condition with disabling consequences. Women have the highest risk of being diagnosed with bipolar or having a recurring episode during pregnancy or within one year of giving birth. Sleep deprivation in postpartum women can lead to worsening of the patient's bipolar disorder. In pregnant and postpartum women who are diagnosed with bipolar disorder, lithium is considered the gold standard for the treatment of bipolar disorder. Lithium can be an effective treatment for controlling symptoms. However, fluctuations in serum lithium levels can lead to subtherapeutic levels during the first and second trimesters and supratherapeutic or even toxic levels in the third trimester and postpartum period. In addition, lithium use during pregnancy carries risks. The American College of Obstetricians and Gynecologists issued new guidelines for lithium use during pregnancy and postpartum to address these risks. In cases where lithium is not preferred, other medications may be appropriate. For example, lamotrigine, an anticonvulsant, is widely considered non-teratogenic and is often used as a safe alternative to lithium in pregnancy.