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bipolar disorder pregnancy

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https://www.readbyqxmd.com/read/29282333/topiramate-use-early-in-pregnancy-and-the-risk-of-oral-clefts-a-pregnancy-cohort-study
#1
Sonia Hernandez-Diaz, Krista F Huybrechts, Rishi J Desai, Jacqueline M Cohen, Helen Mogun, Page B Pennell, Brian T Bateman, Elisabetta Patorno
OBJECTIVE: To assess the relative risk of oral clefts associated with maternal use of high and low doses of topiramate during the first trimester for epilepsy and nonepilepsy indications. METHODS: This population-based study nested in the US 2000-2010 Medicaid Analytic eXtract included a cohort of 1,360,101 pregnant women with a live-born infant enrolled in Medicaid from 3 months before conception through 1 month after delivery. Oral clefts were defined as the presence of a recorded diagnosis in claims during the first 90 days after birth...
December 27, 2017: Neurology
https://www.readbyqxmd.com/read/29275156/aripiprazole-use-during-pregnancy-peripartum-and-lactation-a-systematic-literature-search-and-review-to-inform-clinical-practice
#2
REVIEW
A Cuomo, A Goracci, A Fagiolini
BACKGROUND: Aripiprazole is used relatively frequently in women with bipolar disorder or schizophrenia in childbearing years, owing to its efficacy and relatively favorable side effect profile. As is the case for other psychotropic medications, for ethical reasons, no prospective randomized placebo controlled trial to assess aripiprazole safety during pregnancy has ever been conducted. However, animal data are available and the amount of exposure and outcome data for human fetuses and infants has recently increased, providing published prospective safety data in relatively large numbers of pregnant women treated with aripiprazole...
December 14, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29274567/is-there-consensus-across-international-evidence-based-guidelines-for-the-psychotropic-drug-management-of-bipolar-disorder-during-the-perinatal-period
#3
REVIEW
Rebecca K Graham, Gabriela Tavella, Gordon B Parker
BACKGROUND: Clinicians treating a patient with bipolar disorder who is pregnant or breastfeeding may seek advice from bipolar management guidelines that provide recommendations for perinatal treatment. We examine the consistency of such recommendations across several evidence-based guidelines. METHODS: A literature search in the National Guideline Clearinghouse, the Cochrane Database of Systematic Reviews, PsycInfo and PubMed was undertaken using the search terms "bipolar disorder" and "guidelines," which generated 11 sets of evidence-based guidelines published by professional organizations during the 2005-2015 period...
December 12, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29226616/clinical-characteristics-of-maternal-mental-health-service-users-treated-with-mood-stabilizing-or-antipsychotic-medication
#4
Charmian Møller-Olsen, Susan Hatters Friedman, Chandni Prakash, Abigail North
INTRODUCTION: We aimed to investigate the characteristics of pregnant women who required either mood stabilizer or antipsychotic treatment. These women requiring such treatment are likely to be more mentally unwell and thus carry a higher burden of comorbidities associated with poor pregnancy outcomes. METHODS: This retrospective review investigated the common characteristics of pregnant women who were prescribed with antipsychotics or mood stabilizers under a major city's public maternal mental health service...
December 11, 2017: Asia-Pacific Psychiatry: Official Journal of the Pacific Rim College of Psychiatrists
https://www.readbyqxmd.com/read/29215383/mood-stabilizing-anticonvulsants-spina-bifida-and-folate-supplementation-commentary
#5
Neil Patel, Adele C Viguera, Ross J Baldessarini
PURPOSE/BACKGROUND: High risks of neural tube defects and other teratogenic effects are associated with exposure in early pregnancy to some anticonvulsants, including in women with bipolar disorder. METHODS/PROCEDURES: Based on a semistructured review of recent literature, we summarized findings pertaining to this topic. FINDINGS/RESULTS: Valproate and carbamazepine are commonly used empirically (off-label) for putative long-term mood-stabilizing effects...
February 2018: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29150869/maternal-mood-disorders-and-lithium-exposure-in-utero-were-not-associated-with-poor-cognitive-development-during-childhood
#6
L Forsberg, M Adler, I Römer Ek, M Ljungdahl, L Navér, L L Gustafsson, G Berglund, A Chotigasatien, U Hammar, B Böhm, K Wide
AIM: This study evaluated whether maternal mood disorders, particularly bipolar disorder, and lithium treatment during pregnancy influenced the neonatal health and cognition of children born from 2006- 2010. METHODS: Our study at Karolinska University Hospital, Stockholm, Sweden, focused on women with and without mood disorders and their children. Information on pharmacotherapy, mental health, delivery and neonatal complications was retrospectively collected from electronic patient records...
November 18, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29083536/bipolar-disorder-in-pregnancy-a-review-of-pregnancy-outcomes
#7
REVIEW
Debra A Scrandis
INTRODUCTION: Women with bipolar disorder may benefit from continuation of their medications during pregnancy, but there may be risks to the fetus associated with some of these medications. This article examines the evidence relating to the effect of bipolar disorder and pharmacologic treatments for bipolar disorder on pregnancy outcomes. METHODS: MEDLINE, CINAHL, ProQuest Dissertation & Theses, and the Cochrane Database of Systematic Reviews were searched for English-language studies published between 2000 and 2017, excluding case reports and integrative reviews...
October 30, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29073788/affective-temperaments-during-pregnancy-and-postpartum-period-a-click-to-hyperthymic-temperament
#8
Esra Yazici, Hilal Uslu Yuvaci, Ahmet Bulent Yazici, Arif Serhan Cevrioglu, Atila Erol
BACKGROUND: Pregnancy and postpartum periods are the main reproductive periods during which women experience mood disorders. Affective temperaments are known antecedents of mood disorders and their importance is increasing in time for early diagnosis and determining risky groups. But data about affective temperaments during perinatal period is limited. METHODS: Women during pregnancy and perinatal period and healthy controls who are not in perinatal period are included in the study...
October 26, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28954564/maternal-and-neonatal-outcomes-among-pregnant-women-with-fibromyalgia-a-population-based-study-of-12-million-births
#9
Glenda Gatan Magtanong, Andrea R Spence, Nicholas Czuzoj-Shulman, Haim Arie Abenhaim
PURPOSE: Fibromyalgia (FM) is a rheumatologic disorder marked by chronic, widespread pain and associated comorbid conditions. The purpose of our study was to evaluate the effect of FM on maternal and neonatal outcomes. METHODS: Using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 1999 to 2013, we conducted a population-based retrospective cohort study consisting of women who delivered during that period. Logistic regression was used to compare maternal and neonatal outcomes among pregnancies in women with and without FM...
September 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28953852/prescription-of-sodium-valproate-as-a-mood-stabiliser-in-pregnancy
#10
Kate Womersley
This essay was submitted for the Royal College of Psychiatry's perinatal psychiatry medical student essay prize in 2017. The essay considers the choices available to women with bipolar disorder who become pregnant while taking sodium valproate to treat mania or for mood stabilisation. The implications of three options are considered: to stop all treatment, to switch to a different mood stabiliser or to continue on sodium valproate. The implications for the fetus, on the mother's wellbeing and the ethics of patient choice are discussed...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28837954/is-parity-status-associated-with-bipolar-disorder-clinical-features-severity-or-evolution
#11
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...
January 1, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28800800/behavioral-emergencies-special-considerations-in-the-pregnant-patient
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
November 1, 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
#19
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
#20
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
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