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bipolar disorder pregnancy

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https://www.readbyqxmd.com/read/28837954/is-parity-status-associated-with-bipolar-disorder-clinical-features-severity-or-evolution
#1
Sarah Tebeka, Yann Le Strat, Caroline Dubertret
OBJECTIVE: To assess prospectively the association of the number of past pregnancies on the evolution of bipolar disorder (BD). METHODS: Data were drawn from the 2 waves of the National Epidemiologic Study of Alcohol and Related Conditions (NESARC), a representative sample of the US population of 34,653 participants. All women diagnosed with BD were included. The number of children and BD's characteristics, i.e. BD type, age of onset, hospitalization and suicide attempt, and lifetime psychiatrics comorbidity were assessed at wave 1...
August 16, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28800800/behavioral-emergencies-special-considerations-in-the-pregnant-patient
#2
REVIEW
Awais Aftab, Asim A Shah
This article describes psychiatric emergencies in pregnant women. The perinatal period is a time of psychiatric vulnerability. Up to 1 in 6 pregnant women experience major depressive disorder, and 1 in 4 pregnant women with bipolar disorder experience mood exacerbation. We discuss the management of severe mental illness in pregnancy, risk to mother and child of untreated psychiatric illness in pregnancy, risk of relapse of psychiatric disorders in pregnancy with medication discontinuation, psychopharmacologic considerations of teratogenicity and other fetal adverse effects, acute agitation in the pregnant patient, suicidality in pregnancy, and emergency considerations related to substance use disorders...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28715621/electroconvulsive-therapy-during-pregnancy
#3
Aubrey Thyen, Puneet Narang, Simrat Sarai, Gulay Tegin, Steven Lippmann
Women often experience worsening mood disorder symptoms during pregnancy. Women with mood disorders have an increased risk for suboptimal prenatal care, inadequate weight gain, and more substance abuse during pregnancy. It is often difficult to balance pharmacotherapy risks to a developing fetus versus not medicinally treating maternal mental health conditions. Electroconvulsive therapy (ECT) is a rapid and effective treatment option that can be an appropriate intervention in some women during pregnancy. This report presents an overview of ECT in pregnancy and the case of a 28-year-old pregnant woman with bipolar mania who responded well to ECT...
July 13, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28699029/access-to-pharmacotherapy-amongst-women-with-bipolar-disorder-during-pregnancy-a-preliminary-study
#4
Nancy Byatt, Lucille Cox, Tiffany A Moore Simas, Kathleen Biebel, Padma Sankaran, Holly A Swartz, Linda Weinreb
Bipolar disorder among pregnant women has deleterious effects on birth and child outcomes and is currently under-detected, not addressed effectively, or exacerbated through inappropriate treatment. The goal of this study was to identify perspectives of pregnant and postpartum women with bipolar disorder on barriers and facilitators to psychiatric treatment during pregnancy. In-depth interviews were conducted with pregnant and postpartum women who scored ≥ 10 on the Edinburgh Postnatal Depression Scale and met DSM-IV criteria for bipolar disorder I, II or not otherwise specified using the Mini International Neuropsychiatric Interview version 5...
July 11, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28665044/mood-symptoms-in-pregnant-and-postpartum-women-with-bipolar-disorder-a-naturalistic-study
#5
Kara E Driscoll, Dorothy K Y Sit, Eydie L Moses-Kolko, Emily Pinheiro, Amy Yang, Jody D Ciolino, Heather F Eng, James F Luther, Crystal T Clark, Stephen R Wisniewski, Katherine L Wisner
OBJECTIVE: We conducted a prospective naturalistic study of pregnant women with bipolar disorder (BD) to evaluate symptoms of BD across childbearing and assess whether pharmacotherapy reduced their severity. METHODS: Assessments were scheduled at 20, 30, and 36 weeks' gestation and 2, 12, 26, and 52 weeks postpartum. Symptoms were assessed using the Structured Interview Guide for the Hamilton Depression Rating Scale-Atypical Depression Supplement (SIGH-ADS) and Mania Rating Scale (MRS)...
June 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28657488/the-risks-associated-with-the-use-of-lamotrigine-during-pregnancy
#6
Lingli Kong, Tiantian Zhou, Bailing Wang, Zhenbo Gao, Chunxia Wang
OBJECTIVE: This paper reviewed the relevant literature on the effects of lamotrigine on pregnancy outcomes to provide useful information regarding lamotrigine use in pregnant women with bipolar disorder. METHODS: A systematic search of electronic databases and other original sources was conducted that examined the effects of lamotrigine on pregnancy outcomes. RESULTS: It is not clear that foetuses of lamotrigine-exposed pregnant women are at higher risk of malformation or neurodevelopmental delay...
June 28, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28629296/atypical-antipsychotic-use-and-outcomes-in-an-urban-maternal-mental-health-service
#7
Susan Hatters Friedman, Charmian Moller-Olsen, Chandni Prakash, Abigail North
Objective Despite many women suffering from psychosis in their childbearing years, limited data exist about the use of atypical antipsychotic agents in pregnancy. Atypical antipsychotic agents are often used to treat bipolar disorder, instead of lithium or valproate because of the known teratogenicity of those agents. As well, atypical antipsychotics are often prescribed in anxiety disorders and depression. This study sought to describe pregnancy outcomes for women prescribed atypical antipsychotics during pregnancy...
August 2016: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28617210/antipsychotic-medication-use-among-publicly-insured-pregnant-women-in-the-united-states
#8
Yoonyoung Park, Krista F Huybrechts, Jacqueline M Cohen, Brian T Bateman, Rishi J Desai, Elisabetta Patorno, Helen Mogun, Lee S Cohen, Sonia Hernandez-Diaz
OBJECTIVE: Given the increasing use and broadening of indications for use of antipsychotic medications in the general population, as well as the paucity of information on the safety of this drug class during pregnancy, the study documented patterns of antipsychotic medication use among pregnant women. METHODS: Medicaid Analytic eXtract data (2001-2010) from pregnant women who delivered live-born infants were used. Antipsychotic use at both the class and the individual drug level was defined based on dispensed outpatient prescriptions...
June 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28605109/a-randomized-double-blind-placebo-and-risperidone-controlled-study-on-valnoctamide-for-acute-mania
#9
Mark Weiser, Linda Levi, Stephen Z Levine, Meir Bialer, Tawfeeq Shekh-Ahmad, Valentin Matei, Alexandru Tiugan, Diana Cirjaliu, Cristinel Sava, Eugenia Sinita, Daisy Zamora, John M Davis
OBJECTIVES: Mood stabilizers administered for bipolar disorder during pregnancy, such as valproic acid, can increase the risk of congenital anomalies in offspring. Valnoctamide is a valproic acid derivative associated with a decreased risk for congenital abnormalities in animals. The present study evaluated the efficacy and safety of valnoctamide monotherapy, compared to placebo, in the treatment of patients in an acute manic episode. METHODS: A 3-week, double-blind, randomized, placebo- and risperidone-controlled, parallel group trial was conducted on 173 patients in an acute manic episode...
June 12, 2017: Bipolar Disorders
https://www.readbyqxmd.com/read/28570796/neonatal-discontinuation-syndrome-in-serotonergic-antidepressant-exposed-neonates
#10
MULTICENTER STUDY
Amy Yang, Jody D Ciolino, Emily Pinheiro, Laura J Rasmussen-Torvik, Dorothy K Y Sit, Katherine L Wisner
OBJECTIVE: To determine whether infants exposed in utero to serotonin reuptake inhibitor (SRI) antidepressants or a DSM-IV-TR-defined mood disorder have significantly more neonatal discontinuation signs compared to an unexposed group of infants at 2-4 weeks after birth. METHODS: This secondary analysis was derived from 2 observational studies with enrollment from July 2000 to December 2011 in Cleveland, Ohio, and Pittsburgh, Pennsylvania. Mothers (n = 214) belonged to one of 3 groups based on exposure status during pregnancy: (1) Comparison-women who did not take psychotropics during pregnancy and had no major mood disorder; (2) SRI-exposed-women with a mood disorder who were taking an SRI but no benzodiazepines; and (3) Mood Disorder-women with depression or bipolar disorder who did not take psychotropic medications...
May 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28569088/thoughts-and-considerations-of-women-with-bipolar-disorder-about-family-planning-and-pregnancy-a-qualitative-study
#11
Anja Wilhelmina Margaretha Maria Stevens, Thea Henrica Daggenvoorde, Samuel Martinus Dianshah van der Klis, Ralph Werner Kupka, Peter Jan Joseph Goossens
BACKGROUND: Women with bipolar disorder have an increased risk of relapse during pregnancy and the postpartum period, and they often express broad concerns about family planning. OBJECTIVE: To explore the thoughts and considerations of women of childbearing age with bipolar disorder, about family planning and pregnancy. DESIGN: A qualitative study was conducted: 15 women with bipolar I disorder were individually interviewed. Content analysis was applied...
May 1, 2017: Journal of the American Psychiatric Nurses Association
https://www.readbyqxmd.com/read/28501739/risk-of-postpartum-episodes-in-women-with-bipolar-disorder-after-lamotrigine-or-lithium-use-during-pregnancy-a-population-based-cohort-study
#12
Richard Wesseloo, Xiaoqin Liu, Crystal T Clark, Steven A Kushner, Trine Munk-Olsen, Veerle Bergink
BACKGROUND: Women with bipolar disorder are at high risk for relapse/recurrence postpartum. Among all mood stabilizers, lithium has the largest evidence base for efficacy in the peripartum period, but lamotrigine is increasingly prescribed for bipolar spectrum disorders during pregnancy. The aim of this study was to investigate whether lamotrigine use during pregnancy is as effective as lithium in the prevention of severe episodes postpartum. METHODS: Danish national registries were used to identify pregnancies of women with a diagnosis of bipolar spectrum disorders at the time of conception who used lamotrigine or lithium during pregnancy...
August 15, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28467540/association-between-maternal-smoking-during-pregnancy-and-severe-mental-illness-in-offspring
#13
Patrick D Quinn, Martin E Rickert, Caroline E Weibull, Anna L V Johansson, Paul Lichtenstein, Catarina Almqvist, Henrik Larsson, Anastasia N Iliadou, Brian M D'Onofrio
Importance: Several recent population-based studies have linked exposure to maternal smoking during pregnancy to increased risk of severe mental illness in offspring (eg, bipolar disorder, schizophrenia). It is not yet clear, however, whether this association results from causal teratogenic effects or from confounding influences shared by smoking and severe mental illness. Objective: To examine the association between smoking during pregnancy and severe mental illness in offspring, adjusting for measured covariates and unmeasured confounding using family-based designs...
June 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28437764/the-use-of-lithium-for-the-treatment-of-bipolar-disorder-recommendations-from-clinical-practice-guidelines
#14
Gin S Malhi, Danielle Gessler, Tim Outhred
BACKGROUND: Lithium is an effective mood stabilizer that is used principally for the management of bipolar disorder (BD). Its administration is complex and often requires sophisticated management and assiduous monitoring. When considering the use of lithium therapy for bipolar disorder, clinicians are advised to refer to recommendations outlined in clinical practice guidelines (CPGs); but because of varying emphases placed by different international CPGs, recommendations addressing the practical use of lithium lack consistency...
August 1, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28374064/probable-postpartum-hypomania-and-depression-in-a-south-african-cohort
#15
Janine Pingo, Leigh L van den Heuvel, Bavinisha Vythylingum, Soraya Seedat
The aim of this study was to evaluate the frequency of, and factors associated with, postpartum hypomania (PPH) and postpartum depression (PPD) in a South African sample. Data from 57 women were analysed as part of a larger prospective study of maternal stress in pregnancy. On day 3 postpartum, women were assessed for probable PPH using the Highs scale. On day 3 and at week 6, probable PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS), while social support was evaluated using the Multidimensional Scale of Perceived Social Support (MSPSS)...
April 4, 2017: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/28297592/a-systematized-review-of-atypical-antipsychotics-in-pregnant-women-balancing-between-risks-of-untreated-illness-and-risks-of-drug-related-adverse-effects
#16
REVIEW
Sarah Tosato, Umberto Albert, Simona Tomassi, Felice Iasevoli, Claudia Carmassi, Silvia Ferrari, Maria Giulia Nanni, Alessandra Nivoli, Umberto Volpe, Anna Rita Atti, Andrea Fiorillo
OBJECTIVE: To summarize risks related to (1) illness and (2) second-generation antipsychotic (SGA) treatment in pregnant women and their offspring. Concerning illness-related risks, we focused on bipolar disorder and schizophrenia, psychiatric disorders for which SGAs are preferentially prescribed. DATA SOURCES: PubMed, Ovid, Scopus, PsycINFO, and Cochrane Library were searched from the date of the first available article to October 2015 using the following key terms: pregnancy OR gestation OR bipolar disorder OR schizophrenia...
May 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28089169/the-role-of-n-3-polyunsaturated-fatty-acids-n-3pufas-in-affective-disorders
#17
REVIEW
Valentina Ciappolino, Giuseppe Delvecchio, Carlo Agostoni, Alessandra Mazzocchi, Alfredo Carlo Altamura, Paolo Brambilla
BACKGROUND: Among emerging treatments for depressive disorders several studies suggested that n-3 polyunsaturated fatty acids (n-3PUFAs) supplementation can be used. However, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) differ in terms of biochemistry, metabolism and therapeutic effects. Therefore, a clear picture of their specific and different role on affective disorders has not yet emerged. OBJECTIVES: To investigate the effects of n-3PUFAs on affective disorders including major depression, bipolar disorder and perinatal depression...
December 15, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28040641/psychopharmacological-drug-utilization-patterns-in-pregnant-women-with-bipolar-disorder-a-nationwide-register-based-study
#18
S C Broeks, H Thisted Horsdal, K Glejsted Ingstrup, C Gasse
BACKGROUND: Bipolar disorder is often associated with a lifetime indication for treatment with psychotropic drugs, thus pregnant women face the dilemma whether to continue treatment or not. This study describes the psychopharmacological drug utilization patterns among women with bipolar disorder from 12 months preconception to 12 months postpartum. METHODS: We conducted a register-based cohort study among all Danish women aged 15-55 with a diagnosis of bipolar disorder, who gave birth to their first and singleton child between January 1997 and December 2012...
March 1, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/27992666/lithium-toxicity-in-a-pregnant-woman
#19
Nasim Zamani, Maryam Paeezi, Hossein Hassanian-Moghaddam
Lithium is recommended in bipolar disorder and can be accompanied by significant toxicity in pregnant women. A 25-year-old single-gestation pregnant woman (28 weeks) was referred with suspicion of lithium toxicity. Serum lithium was 2.1 meq/L. Despite conservative therapy with intravenous fluids, lithium concentration increased to 5.0 meq/L 6 hr after admission mandating an emergent haemodialysis during which foetal heart rate decreased to 90 bpm. The gynaecologist ordered termination of pregnancy while the mother was still on haemodialysis...
May 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27938868/antenatal-and-postnatal-risk-factors-of-postpartum-depression-symptoms-in-thai-women-a-case-control-study
#20
Chutima Roomruangwong, Sinaporn Withayavanitchai, Michael Maes
OBJECTIVE: To examine the effects of different predictors on the incidence and severity of postpartum depression (PPD) symptoms in a Thai population. METHODS: In this case control study we delineate the clinical, demographic and socio-economic risk factors associated with PPD symptoms. We used the Edinburgh Postnatal Depression Scale (EPDS) 4-6 weeks postpartum to divide parturients into those with (n = 53) and without (n = 260) PPD using a cutoff score of 11...
December 2016: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
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