Adele Viguera, MD, MPH, Assistant Professor of Psychiatry, Director of Clinical Research, Center for Women’s Mental Health, Cleveland Clinic, discusses lithium use in pregnancy, one of the oldest known teratogens, and the concept of relative versus absolute risk when discussing this with bipolar patients.
Summary:
Lithium use in pregnancy carries a risk of Ebstein’s Anomaly between 1 in 1000 and 1 in 2000, and physicians should discuss relative vs absolute risk with their pregnant patients, taking into account severity of illness.
References and Resources:
Howland RH. Prescribing psychotropic medications during pregnancy and lactation: principles and guidelines. J Psychosoc Nurs Ment Health Serv. 2009 May;47(5):19-23. Review.
Nguyen HT, Sharma V, McIntyre RS. Teratogenesis associated with antibipolar agents. Adv Ther. 2009 Mar;26(3):281-94. Epub 2009 Mar 28.
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Lamotrigine and valproic acid in pregnancy
Bipolar disorder and pregnancy
Medication doses in pregnancy and bipolar disorder
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