Analysis of Perinatal Women Attending a Mother and Baby Unit Taking Sodium Valproate or Lithium with a Diagnosis of Bipolar Affective Disorder

Lebedevs, Tamara; Gan, Malorie; Teoh, Stephanie; Brown, Philippa M.

doi:10.1007/s11126-020-09729-2

Cited by 7 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Though several studies were determined to lack methodological quality (Battle et al, 2006 , 2008 ; Bergink et al, 2011 ; Hill et al, 2019 ; Lebedevs et al, 2020 ; Patel et al, 2005 ; Sakellari et al, 2020 ), we did not exclude these based on rigour. Two papers received a ‘yes’ to all critical appraisal questions (Artzi‐Medvedik et al, 2012 ; Challacombe et al, 2016 ), while the remaining studies had some methodological limitations (Baker et al, 2021 ; Bogen et al, 2010 ; Dolman et al, 2016 ; Martini et al, 2019 ; McCauley et al, 2014 ; Pearlstein et al, 2006 ; Taylor et al, 2022 ; Torgersen et al, 2010 ; Xu et al, 2014 ).…”

Section: Resultsmentioning

confidence: 99%

A mixed methods systematic review exploring infant feeding experiences and support in women with severe mental illness

Baker,

Bick,

Bamber

et al. 2023

Maternal & Child Nutrition

View full text Add to dashboard Cite

There are many benefits of breastfeeding to women and their infants but meeting the recommended 6 months of exclusive breastfeeding is likely to be more challenging for women with severe mental illness (SMI). This is the first systematic review that aims to examine evidence of (a) infant feeding outcomes in women with SMI and the factors associated with this, (b) the experiences of infant feeding and infant feeding support for women with SMI, (c) interventions for supporting infant feeding among these women and (d) health care professionals' attitudes toward supporting infant feeding in women with SMI. Mixed methods systematic review was carried out using the principles of Joanna Briggs Institute's (JBI) 'convergent integrated' methodology. CINAHL, PsycINFO, Medline and MIDIRS were used to search literature between 1994 and 2022. The quality of selected articles was assessed using JBI critical appraisal tools and thematic synthesis was undertaken to obtain findings. Eighteen papers were included in the final review. Women with SMI were less likely to initiate and continue breastfeeding than women without SMI. Several challenges with breastfeeding were highlighted, and while these were often linked to women's mental health difficulties, inconsistent advice from health care professionals and poor support with breastfeeding further compounded these challenges. This review highlights that policy and practice need to take into account the individual challenges women with SMI face when planning, initiating and maintaining breastfeeding. Education and training for health care professionals are needed to enable them to provide tailored infant feeding support to women with SMI, which reflects their individual needs.

show abstract

Section: Resultsmentioning

confidence: 99%

A mixed methods systematic review exploring infant feeding experiences and support in women with severe mental illness

Baker,

Bick,

Bamber

et al. 2023

Maternal & Child Nutrition

View full text Add to dashboard Cite

show abstract

“…[8] In contrast, it is suggested to change pharmacotherapy from lithium precisely to breastfeeding sodium valproate. [18] Significant progress has been made in understanding the hepatotoxicity, teratogenicity and fetotoxicity of sodium valproate which provides opportunities to prevent them and long-term administration of this drug is relatively safe. [17] Because of the possibility of a causal relationship with PCOS, the NICE guideline on bipolar disorder recommends avoiding valproate in women aged < 18 years.…”

Section: Effect Of Valproate On a Woman Increased Hepatic Clearance O...mentioning

confidence: 99%

What are the effects of taking 300 pills of sodium valproate? - case report

Pożarowska

Brzuszkiewicz

Rudziński

et al. 2022

J Educ Health Sport

View full text Add to dashboard Cite

INTRODUCTION: Sodium valproate is one of the most important antiepileptic drugs. It can be effective as a preventive treatment for migraine, it has also found use in the maintenance treatment of bipolar disorder and acute mania,it is sometimes used in the treatment of chronic neuropathic pain and fibromyalgia, in the treatment of schizophrenia borderline personality disorder and acquired brain injury, this drug is used off-label. Its overdose can be fatal. MATERIALS AND METHOD: Patient information was collected from hospital records available in the clinical toxicology department. In addition, we conducted a literature review on sodium valproate treatment, its toxicity, side effects and pharmacokinetics using PubMed. CASE REPORT: A 57-year-old patient with a history of depressive disorders was admitted to the Clinical Department of Toxicology and Cardiology in Lublin for intentional intoxication with the drug Absenor (sodium valproate). The patient had taken 3 packages of Absenor 500 mg (300 tablets in total) for suicidal purposes. The determined concentration of valproic acid was 841 µg/ml, and the patient's condition was very severe. Despite the treatment administered-multiple attempts at gastric lavage, administration of activated charcoal, performance of hemodialysis procedures, administration of infusion of catecholamines, the patient died on the fifth day of hospitalization. CONCLUSION: An overdose of sodium valproate can be fatal. Keep this in mind when ordering this drug for patients with a positive history of suicide attempts.

show abstract

“…80,81 A third study noted a higher rate of relapse among postpartum women who switched from lithium to sodium valproate to breastfeed (4/7) than among women who stayed on lithium (1/9); however, small numbers limit our ability to make conclusions. 190 The evidence for depression is mixed. Three studies compared evaluated outcomes for those discontinuing medications with those continuing medications through pregnancy.…”

Section: Findings In Relation To the Decisional Dilemmamentioning

confidence: 99%

Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions

Viswanathan¹,

Middleton²,

Stuebe³

et al. 2021

View full text Add to dashboard Cite

Background. Untreated maternal mental health disorders can have devastating sequelae for the mother and child. For women who are currently or planning to become pregnant or are breastfeeding, a critical question is whether the benefits of treating psychiatric illness with pharmacologic interventions outweigh the harms for mother and child. Methods. We conducted a systematic review to assess the benefits and harms of pharmacologic interventions compared with placebo, no treatment, or other pharmacologic interventions for pregnant and postpartum women with mental health disorders. We searched four databases and other sources for evidence available from inception through June 5, 2020 and surveilled the literature through March 2, 2021; dually screened the results; and analyzed eligible studies. We included studies of pregnant, postpartum, or reproductive-age women with a new or preexisting diagnosis of a mental health disorder treated with pharmacotherapy; we excluded psychotherapy. Eligible comparators included women with the disorder but no pharmacotherapy or women who discontinued the pharmacotherapy before pregnancy. Results. A total of 164 studies (168 articles) met eligibility criteria. Brexanolone for depression onset in the third trimester or in the postpartum period probably improves depressive symptoms at 30 days (least square mean difference in the Hamilton Rating Scale for Depression, -2.6; p=0.02; N=209) when compared with placebo. Sertraline for postpartum depression may improve response (calculated relative risk [RR], 2.24; 95% confidence interval [CI], 0.95 to 5.24; N=36), remission (calculated RR, 2.51; 95% CI, 0.94 to 6.70; N=36), and depressive symptoms (p-values ranging from 0.01 to 0.05) when compared with placebo. Discontinuing use of mood stabilizers during pregnancy may increase recurrence (adjusted hazard ratio [AHR], 2.2; 95% CI, 1.2 to 4.2; N=89) and reduce time to recurrence of mood disorders (2 vs. 28 weeks, AHR, 12.1; 95% CI, 1.6 to 91; N=26) for bipolar disorder when compared with continued use. Brexanolone for depression onset in the third trimester or in the postpartum period may increase the risk of sedation or somnolence, leading to dose interruption or reduction when compared with placebo (5% vs. 0%). More than 95 percent of studies reporting on harms were observational in design and unable to fully account for confounding. These studies suggested some associations between benzodiazepine exposure before conception and ectopic pregnancy; between specific antidepressants during pregnancy and adverse maternal outcomes such as postpartum hemorrhage, preeclampsia, and spontaneous abortion, and child outcomes such as respiratory issues, low Apgar scores, persistent pulmonary hypertension of the newborn, depression in children, and autism spectrum disorder; between quetiapine or olanzapine and gestational diabetes; and between benzodiazepine and neonatal intensive care admissions. Causality cannot be inferred from these studies. We found insufficient evidence on benefits and harms from comparative effectiveness studies, with one exception: one study suggested a higher risk of overall congenital anomalies (adjusted RR [ARR], 1.85; 95% CI, 1.23 to 2.78; N=2,608) and cardiac anomalies (ARR, 2.25; 95% CI, 1.17 to 4.34; N=2,608) for lithium compared with lamotrigine during first- trimester exposure. Conclusions. Few studies have been conducted in pregnant and postpartum women on the benefits of pharmacotherapy; many studies report on harms but are of low quality. The limited evidence available is consistent with some benefit, and some studies suggested increased adverse events. However, because these studies could not rule out underlying disease severity as the cause of the association, the causal link between the exposure and adverse events is unclear. Patients and clinicians need to make an informed, collaborative decision on treatment choices.

show abstract

Analysis of Perinatal Women Attending a Mother and Baby Unit Taking Sodium Valproate or Lithium with a Diagnosis of Bipolar Affective Disorder

Cited by 7 publications

References 9 publications

A mixed methods systematic review exploring infant feeding experiences and support in women with severe mental illness

A mixed methods systematic review exploring infant feeding experiences and support in women with severe mental illness

What are the effects of taking 300 pills of sodium valproate? - case report

Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Systematic Review of Perinatal Pharmacologic Interventions

Contact Info

Product

Resources

About