Adele Viguera, MD, MPH, Assistant Professor of Psychiatry, Director of Clinical Research, Center for Women’s Mental Health, Cleveland Clinic, discusses anticonvulsant use in bipolar disorder and pregnancy, citing the teratogenic risks of valproic acid and lamotrigine, and balancing these with the risk of the mother relapsing.
Summary:
Lamotrigine and valrpoic acid use in pregnant women with bipolar disorder must be balanced with the risk of maternal relapses; valproic acid has a risk of around 10% for major fetal malformations and lamotrigine appears to carry a risk of cleft palate if given in the first trimester.
References and Resources
Nguyen HT, Sharma V, McIntyre RS. Teratogenesis associated with antibipolar agents. Adv Ther. 2009 Mar;26(3):281-94. Epub 2009 Mar 28.
Sharma V. Management of bipolar II disorder during pregnancy and the postpartum period–Motherisk Update 2008. Can J Clin Pharmacol. 2009 Winter;16(1):e33-41. Epub 2009 Jan 22.
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