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Published on: June 10, 2013
Mood stabilizers during breastfeeding: a review.
1William S. Middleton Memorial Veterans Affairs Hospital and the University of Wisconsin Medical School, USA.
The Journal of Clinical Psychiatry
|March 25, 2000
Summary
Postpartum bipolar disorder relapse is common. While some mood stabilizers are considered safe for breastfeeding, limited data and adverse events necessitate personalized treatment plans based on individual patient history and clinical factors.
Area of Science:
- Perinatal Psychiatry
- Pharmacology
- Maternal-Infant Health
Background:
- Postpartum period poses high risk for bipolar disorder recurrence (depression, mania, psychosis).
- Mood stabilizers are used for puerperal prophylaxis to mitigate relapse risk.
- Informed decisions on mood stabilizer use during breastfeeding require critical data analysis.
Purpose of the Study:
- To review and analyze existing data on mood stabilizer use during breastfeeding.
- To inform clinical practice regarding medication choices for breastfeeding mothers with bipolar disorder.
Main Methods:
- Comprehensive literature search of MEDLINE and the Lithium Database (1966-1998).
- Included studies on lithium, valproate, carbamazepine, gabapentin, and lamotrigine use during lactation.
- Incorporated unpublished data for gabapentin and lamotrigine.
Main Results:
- Limited case reports available for lithium, valproate, carbamazepine, and lamotrigine.
- Adverse events noted: lithium toxicity, thrombocytopenia, anemia, and hepatic dysfunction in infants.
- Data often confounded by polypharmacy and varying infant ages.
Conclusions:
- Current data on mood stabilizers during breastfeeding is limited and primarily from uncontrolled studies.
- Reassessment of recommendations is needed due to data paucity and reported adverse reactions.
- Individualized treatment decisions, considering patient history and clinical context, are crucial for selecting mood stabilizers during breastfeeding.
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