Bipolar Disorder and Pregnancy

Women with a history of bipolar disorder are at an increased risk of having a bipolar episode during pregnancy. Bipolar disorder may begin during pregnancy or after the birth of the baby for some women. In either of these cases, it is essential to take special care.

Medication in Bipolar Disorder and Pregnancy

The greatest challenge associated with bipolar disorder in pregnancy patients is medication because taking medication during pregnancy adversely affects the fetus.

It is absolutely not advisable to stop taking medication at any time as a bipolar disorder patient as it will cause drastic mood changes.

Any medication taken in the first three months of pregnancy must be prescribed very carefully. Treatment and medication must be balanced against the risk to the fetus and the mother’s illness.

Pregnant and new mothers who are bipolar disorder patients have seven times higher risk of hospital admission and double the risk for a recurrent episode.

Pregnancy usually demands some medication changes, which may increase the side effects and/or cause damage to the fetus. These changes also increase the risk of relapse of the illness. To avoid these problems, the following precautions must be taken by pregnant bipolar patients :

• Prevention of Relapse – This is an essential aspect of prenatal care for women with a history of bipolar disorder. Relapse happens if the woman discontinues her medication, so it is advisable to consult the doctor about altering the medication during pregnancy.
• Planning the pregnancy – When a bipolar disorder patient is planning to conceive, it is necessary to consult with the doctor regarding the medication. In some cases, you can opt for a drug-free conception. If the patients have had low severity of and frequency of episodes, a planned pregnancy without drugs may be considered. If medication is necessary, the consultation will help select medication based on the severity of symptoms. High-dose folate should be started before becoming pregnant to reduce the risk of spinal and neural tube defects.
• Hospitalization – The care and safety of the mother and child are of concern. For this reason, whenever an episode of relapse happens, hospitalization and care are necessary.