Psychotropic drug use in perinatal women with bipolar disorder

Research output: Contribution to journalReview article

Abstract

Optimal dose management of psychotropic drugs during the perinatal period reduces the risk for recurrence of mood episodes in women with Bipolar Disorder. Physiological changes during pregnancy are associated with decreases in the plasma concentrations of the majority of mood stabilizing medications. Regular symptom and drug concentration monitoring for lithium and anticonvulsants with reflexive dose adjustment improves the probability of sustained symptom remission across pregnancy. The elimination clearance trajectory across pregnancy for psychotropics dictates the frequency of laboratory monitoring and dose adjustment. The literature on the pharmacokinetics of lithium, lamotrigine, carbamazepine and atypical antipsychotics during pregnancy and postpartum are reviewed, recommendations for symptom and laboratory monitoring are proposed and recommendations for dose adjustments are presented.

Original languageEnglish (US)
Article number151230
JournalSeminars in Perinatology
DOIs
StateAccepted/In press - Jan 1 2020

    Fingerprint

Keywords

  • Atypical antipsychotics
  • Bipoalr disorder
  • Carbamazepine
  • Elimination clearance
  • Lamotrigine
  • Lithium
  • Olanzapine
  • Perinatal
  • Pharmacology
  • Postpartum
  • Pregnancy
  • Quetiapine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this