Discontinuing mood stabilizer treatment presents high risks of illness-recurrence among pregnant women diagnosed with BPD. LTG may afford protective effects in pregnancy, and its reported fetal safety compares favorably to other agents used to manage BPD.

To examine the extent and clinical sequelae of fetal exposure to zolpidem, a commonly prescribed hypnotic agent. Pregnant women with psychiatric illness participating in a study of psychotropic pharmacokinetics were included. Zolpidem concentrations were analyzed in maternal and umbilical cord plasma collected at delivery. Outcomes were compared between the zolpidem-exposed group and a 1:1 matched comparator group. Forty-five women taking zolpidem during pregnancy were studied. Rates of preterm delivery and low birth weight were 26.7% and 15.6% respectively in the zolpidem-exposed group versus 13.3% and 4.4% in the matched comparator group, but no significant differences were found. The ratio of umbilical cord to maternal plasma zolpidem concentrations in 6 pairs ranged from 0.48 to 2.75. Zolpidem crosses the human placenta and rapidly clears the fetal circulation. Pregnant women with psychiatric illness treated with zolpidem may have less optimal obstetrical outcome, though it is unclear if this was related to the medication.

No abstract

Cardiovascular disorders in acute multiple sclerosis (MS) relapse have been infrequently reported. We present a young multiple sclerosis patient with acute onset of cerebellar symptomatology along with sinus bradycardia. Brain magnetic resonance imaging showed one lesion in the left cerebellar hemisphere which showed postcontrast enhancement and one in the midbrain without postcontrast enhancement. No cardiac pathology was found and symptoms gradually improved after a 5-day course of corticosteroid therapy. It is important to bear in mind the possibility of these rare cardiac symptoms in MS patients, because of their timely recognition and appropriate treatment.