Pharmacotherapy of bipolar II disorder during and after pregnancy

Abstract

The findings of this prospective, observational study indicate that the recurrence risk is much higher after childbirth than during pregnancy in spite of higher utilization of psychotropic drugs in the postpartum period.

Mood symptoms in pregnant and postpartum women with bipolar disorder: a naturalistic study

“…Patients with chronic BD were significantly less likely to experience severe episodes postpartum (17%) compared to women with a history of only postpartum psychosis (29%), who have a specific vulnerability to postbirth relapse. In a prospective observational study of pharmacotherapy in 37 women with BD II across childbearing, Sharma et al 13 reported that the majority of women (54%) did not take psychotropic medication, approximately one-third received monotherapy, and the remainder were treated with combination therapy. During the postpartum period, the majority (86%) of women were treated with psychotropic medication; about one-third received monotherapy, and over half were treated with combination therapy.…”

Pregnancy and bipolar disorder: the risk of recurrence when discontinuing treatment with mood stabilisers: a systematic review

“…8. In a prospective, observational study of 37 women with bipolar II, disorder Sharma et al (20) evaluated pharmacotherapy during pregnancy and the postpartum period. During pregnancy, the majority of participants (54%) were not on any psychotropic medication; approximately one-third (35%) received monotherapy, and the rest received combination therapy.…”

How should we manage bipolar II disorder in the perinatal period?

“…Therefore, the risk/benefit ratio of prescribing prophylactic medication in bipolar II disorder is less clear, which may make it difficult for clinicians to advise women on the best management of this condition during pregnancy and the postnatal period. Sharma et al (2013) studied 37 pregnant women with an existing diagnosis of bipolar II disorder, and found that during pregnancy just over half of participants (54%) were not taking any psychotropic medication, approximately one-third (32%) received monotherapy and the rest were taking combination therapy. In comparison, during the postpartum period only 14% of participants were not on any psychotropic medication.…”