Psychotropic drug use in perinatal women with bipolar disorder

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...

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Bibliographic Details
Published inSeminars in perinatology Vol. 44; no. 3; p. 151230
Main Author Clark, Crystal T.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.04.2020
Subjects
Atypical antipsychotics
Bipoalr disorder
Carbamazepine
Elimination clearance
Lamotrigine
Lithium
Olanzapine
Perinatal
Pharmacology
Postpartum
Pregnancy
Quetiapine
Pregnancy
Atypical antipsychotics
Olanzapine
Perinatal
Lithium
Elimination clearance
Pharmacology
Carbamazepine
Quetiapine
Bipoalr disorder
Lamotrigine
Postpartum
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Summary: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.
ISSN:0146-0005
1558-075X
DOI:10.1016/j.semperi.2020.151230