Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder
Introduction The pharmacological management of women with bipolar disorder in the perinatal period is challenging. This population has a high recurrence rate, but some medications can be a concern in pregnancy and breastfeeding. Little is known about prescribing practices in perinatal services, an...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-04-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933821002406/type/journal_article |
| _version_ | 1827754059193384960 |
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| author | M. Casanova Dias I. Jones A. Wieck |
| author_facet | M. Casanova Dias I. Jones A. Wieck |
| author_sort | M. Casanova Dias |
| collection | DOAJ |
| description |
Introduction
The pharmacological management of women with bipolar disorder in the perinatal period is challenging. This population has a high recurrence rate, but some medications can be a concern in pregnancy and breastfeeding. Little is known about prescribing practices in perinatal services, and the impact of medication on recurrence rates.
Objectives
To describe 1. the use of medication in women with bipolar disorder in the perinatal period and 2. the impact of medication on the rate of recurrence.
Methods
Clinical data was collected from pregnant women with diagnosis of bipolar disorder in the nine participating centres and who were not experiencing an episode of illness entering the postpartum period. Data were analysed for association using χ2 tests and logistic regression.
Results
In this sample of 167 women, 55% were taking medication at delivery: 37% antipsychotics, 15% mood stabilisers, 25% antidepressants. In 12 cases medication was reduced before delivery. 42% experienced a recurrence, with 30% being a manic/psychotic episode. There was no significant association between taking medication and recurrence c2(1)=0.72, p=0.79. There continued to be no association when adjusted for severity (previous admissions, age at first treatment, bipolar subtype) and type of medication OR 0.57 95%CI [0.08; 4.29], p=0.59.
Conclusions
A high number of bipolar women are taking medication before delivery and in the majority antipsychotics are prescribed. The postnatal recurrence rate in both medicated and unmedicated women is high. Further work is needed in larger samples to provide clinical guidance for women and their clinicians.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:44:07Z |
| format | Article |
| id | doaj.art-4908fd8932764750871bb44dd29ca5ce |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:44:07Z |
| publishDate | 2021-04-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-4908fd8932764750871bb44dd29ca5ce2023-11-17T05:07:53ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-04-0164S80S8010.1192/j.eurpsy.2021.240Multicentre evaluation of perinatal pharmacological management in women with bipolar disorderM. Casanova Dias0I. Jones1A. Wieck2National Centre For Mental Health, School Of Medicine, Cardiff University, Cardiff, United KingdomNational Centre For Mental Health, School Of Medicine, Cardiff University, Cardiff, United KingdomGreater Manchester Mental Health Foundation Trust, University of Manchester, Manchester, United Kingdom Introduction The pharmacological management of women with bipolar disorder in the perinatal period is challenging. This population has a high recurrence rate, but some medications can be a concern in pregnancy and breastfeeding. Little is known about prescribing practices in perinatal services, and the impact of medication on recurrence rates. Objectives To describe 1. the use of medication in women with bipolar disorder in the perinatal period and 2. the impact of medication on the rate of recurrence. Methods Clinical data was collected from pregnant women with diagnosis of bipolar disorder in the nine participating centres and who were not experiencing an episode of illness entering the postpartum period. Data were analysed for association using χ2 tests and logistic regression. Results In this sample of 167 women, 55% were taking medication at delivery: 37% antipsychotics, 15% mood stabilisers, 25% antidepressants. In 12 cases medication was reduced before delivery. 42% experienced a recurrence, with 30% being a manic/psychotic episode. There was no significant association between taking medication and recurrence c2(1)=0.72, p=0.79. There continued to be no association when adjusted for severity (previous admissions, age at first treatment, bipolar subtype) and type of medication OR 0.57 95%CI [0.08; 4.29], p=0.59. Conclusions A high number of bipolar women are taking medication before delivery and in the majority antipsychotics are prescribed. The postnatal recurrence rate in both medicated and unmedicated women is high. Further work is needed in larger samples to provide clinical guidance for women and their clinicians. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933821002406/type/journal_articlebipolar disorderpregnancyPostpartumperinatal |
| spellingShingle | M. Casanova Dias I. Jones A. Wieck Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder European Psychiatry bipolar disorder pregnancy Postpartum perinatal |
| title | Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder |
| title_full | Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder |
| title_fullStr | Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder |
| title_full_unstemmed | Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder |
| title_short | Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder |
| title_sort | multicentre evaluation of perinatal pharmacological management in women with bipolar disorder |
| topic | bipolar disorder pregnancy Postpartum perinatal |
| url | https://www.cambridge.org/core/product/identifier/S0924933821002406/type/journal_article |
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