Bipolar Disorder in Pregnancy and Postpartum: Principles of Management

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Pregnancy and postpartum represent times of increased vulnerability for women with bipolar disorder, yet this condition remains under-diagnosed and under-treated. As 50 % of pregnancies are unplanned, the risks associated with the illness and the potential risks associated with treatment should be considered when a woman of reproductive age first presents for evaluation. This article reviews the epidemiology of perinatal bipolar disorder, screening recommendations, and treatment with pharmacotherapy and electroconvulsive therapy (ECT). An overview of the data in pregnancy and lactation is presented for lithium, lamotrigine, valproic acid, newer antipsychotics, and ECT. General principles of management include close monitoring in pregnancy and postpartum, careful adjustment of the treatment regimen to attenuate the risk of relapse, and avoidance of valproic acid when possible. Thoughtful consideration of these issues will minimize the risks to the mother and baby.

Original languageEnglish
Article number13
Pages (from-to)1-11
Number of pages11
JournalCurrent Psychiatry Reports
Issue number2
StatePublished - 1 Feb 2016


  • Antipsychotics
  • Bipolar disorder
  • Depression
  • Lactation
  • Mood stabilizers
  • Neonatal complications
  • Neurodevelopmental effects
  • Perinatal
  • Postpartum
  • Pregnancy
  • Teratogenicity


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