Prophylactic Management of Women With Bipolar Disorder During Pregnancy and the Perinatal Period: Clinical Scenario-Based Practical Recommendations From A Group of Perinatal Psychiatry Authors

Faruk Uguz; Verinder Sharma; Philip Boyce; Crystal T Clark; Megan Galbally; Alexia Koukopoulos; Wendy Marsh; Anja Stevens; Adele Viguera

doi:10.1097/JCP.0000000000001740

Prophylactic Management of Women With Bipolar Disorder During Pregnancy and the Perinatal Period: Clinical Scenario-Based Practical Recommendations From A Group of Perinatal Psychiatry Authors

J Clin Psychopharmacol. 2023 Sep-Oct;43(5):434-452. doi: 10.1097/JCP.0000000000001740.

Authors

Faruk Uguz¹, Verinder Sharma², Philip Boyce³, Crystal T Clark⁴, Megan Galbally⁵, Alexia Koukopoulos⁶, Wendy Marsh⁷, Anja Stevens⁸, Adele Viguera⁹

Affiliations

¹ From the Department of Psychiatry, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
² Schulich School of Medicine and Dentistry, The University of Western Ontario; Lawson Health Research Institute; Parkwood Institute Mental Health, Perinatal Mental Health Clinic, London Health Sciences Center, London, Ontario, Canada.
³ Westmead Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
⁴ Department of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Northwestern Feinberg School of Medicine, Chicago, IL.
⁵ Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Australia.
⁶ University Hospital Policlinico Umberto I, La Sapienza University of Rome; Centro Lucio Bini, Rome, Italy.
⁷ Department of Psychiatry, University of Massachusetts Medical School/UMass Memorial Medical Center, Worcester, MA. [email protected].
⁸ Centre for Bipolar Disorders, Dimence Group, Deventer, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Psychiatry, the Netherlands.
⁹ Cleveland Clinic, Cleveland Clinic Neurological Institute, Cleveland, OH.

PMID: 37683233
DOI: 10.1097/JCP.0000000000001740

Abstract

Many women with bipolar disorder experience episodes of illness or relapses over the perinatal period, especially in the immediate postpartum period. Risks associated with treated/untreated psychopathologies and fetal exposure to bipolar medications make the management of bipolar disorder during these periods challenging for clinicians and patients. In light of the available effectiveness and reproductive safety data, the current clinical update based on the opinions of a group of international perinatal psychiatry authors recommends general considerations and specific management strategies for each possible clinical scenario, including mixed features, predominant polarity, diagnosis of subtypes of bipolar disorder, severity of previous episodes, and risk of recurrence of mood episodes.

MeSH terms

Bipolar Disorder* / diagnosis
Bipolar Disorder* / drug therapy
Female
Humans
Postpartum Period
Pregnancy
Pregnancy Complications* / diagnosis
Pregnancy Complications* / drug therapy