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Multicentre evaluation of perinatal pharmacological management in women with bipolar disorder

Published online by Cambridge University Press:  13 August 2021

M. Casanova Dias ,
I. Jones  and
A. Wieck
M. Casanova Dias*
Affiliation:
National Centre For Mental Health, School Of Medicine, Cardiff University, Cardiff, United Kingdom
I. Jones
Affiliation:
National Centre For Mental Health, School Of Medicine, Cardiff University, Cardiff, United Kingdom
A. Wieck
Affiliation:
Greater Manchester Mental Health Foundation Trust, University of Manchester, Manchester, United Kingdom
*
*Corresponding author.

Abstract

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Introduction

The pharmacological management of women with bipolar disorder in the perinatal period is challenging. This population has a high recurrence rate, but some medications can be a concern in pregnancy and breastfeeding. Little is known about prescribing practices in perinatal services, and the impact of medication on recurrence rates.

Objectives

To describe 1. the use of medication in women with bipolar disorder in the perinatal period and 2. the impact of medication on the rate of recurrence.

Methods

Clinical data was collected from pregnant women with diagnosis of bipolar disorder in the nine participating centres and who were not experiencing an episode of illness entering the postpartum period. Data were analysed for association using χ2 tests and logistic regression.

Results

In this sample of 167 women, 55% were taking medication at delivery: 37% antipsychotics, 15% mood stabilisers, 25% antidepressants. In 12 cases medication was reduced before delivery. 42% experienced a recurrence, with 30% being a manic/psychotic episode. There was no significant association between taking medication and recurrence c2(1)=0.72, p=0.79. There continued to be no association when adjusted for severity (previous admissions, age at first treatment, bipolar subtype) and type of medication OR 0.57 95%CI [0.08; 4.29], p=0.59.

Conclusions

A high number of bipolar women are taking medication before delivery and in the majority antipsychotics are prescribed. The postnatal recurrence rate in both medicated and unmedicated women is high. Further work is needed in larger samples to provide clinical guidance for women and their clinicians.

Disclosure

No significant relationships.

Keywords

bipolar disorderpregnancyPostpartumperinatal
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S80
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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