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Using a Murine Model of Psychosocial Stress in Pregnancy as a Translationally Relevant Paradigm for Psychiatric Disorders in Mothers and Infants
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Psychotropic drug use in perinatal women with bipolar disorder

Crystal T Clark1

  • 1Department of Psychiatry and Behavioral Sciences, Department of Obstetrics and Gynecology, Asher Center for the Study and Treatment of Depressive Disorders, Northwestern University, United States.

Seminars in Perinatology
|March 11, 2020
PubMed

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.

Keywords:
Atypical antipsychoticsBipoalr disorderCarbamazepineElimination clearanceLamotrigineLithiumOlanzapinePerinatalPharmacologyPostpartumPregnancyQuetiapine

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