Last update July 18, 2022

Bipolar Disorder

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

El puerperio es un periodo de mayor riesgo de presentar síntomas psiquiátricos y recurrencias de episodios de enfermedad psiquiátrica. (Pacchiarotti 2016). Postpartum psychosis affects one to two women per 1,000 births. (Seyfried 2003)

La lactancia materna es la forma de alimentación más segura y beneficiosa para el lactante y para la madre, incluso en los trastornos psiquiátricos.

Breastfeeding decreases the risk of hospitalization for an affective or psychiatric disorder in the first year after childbirth. (Xu 2014)

La lactancia durante más de un año se asocia con un menor riesgo de aparición de trastorno bipolar en la posmenopausia. (Kim 2022)

Las madres afectas de enfermedad psiquiátrica amamantan menos frecuentemente y durante menos tiempo (Viguera 2022,). La lactancia materna necesita el apoyo de los equipos de Psiquiatría y Pediatría. (Payne 2019). Es preciso apoyo familair y cuidar el sueño de la madre lactante. (Sharma 2009)

Es necesario vigilar la aparición en el lactante de posibles efectos secundarios como la sedación (posible somnolencia excesiva y disminución de la alimentación) (Sinha 2021, Payne 2019) y, menos frecuentemente, rigidez y síntomas extrapiramidales.

Si la medicación que toma la madre puede controlarse a través de los niveles en sangre, se deben controlar los niveles plasmáticos del lactante de forma intermitente y según sea necesario.

Algunos medicamentos de uso psiquiátrico aumentan los niveles plasmáticos de prolactina y pueden provocar excesiva producción de leche. (Peuskens 2014)

Muchos medicamentos utilizados en Psiquiatría son compatibles con la lactancia (Uguz 2021 y 2016, Payne 2019, McAllister 2017, Vitale 2016). La mayoría de antidepresivos, ansiolíticos y estabilizadores del ánimo son compatibles con la lactancia (Birnbaum 1999). El uso materno de antipsicóticos de segunda generación no se asocia con efectos adversos en el lactante (Viguera 2022). El litio es una posible opción con dosis mínima eficaz y estrecha supervisión clínica y analítica (Rybakowski 2019, Uguz 2016, Vitale 2016, Pacchiarotti 2016, Larsen 2015, Sharma 2009), la carbamazepina y el ácido valproico se consideran relativamente seguros y la lamotrigina se puede usar a las dosis más bajas (Rybakowski 2019, Uguz 2016, Pacchiarotti 2016, Grover 2015, Larsen 2015, Wakil 2009, Sharma 2009). Entre los antipsicóticos, la quetiapina y la olanzapina deben considerarse opciones de tratamiento de primera línea (Teodorescu 2020, Rybakowski 2019, Vitale 2016, Pacchiarotti 2016, Larsen 2015). La risperidona puede ser compatible con la lactancia bajo supervisión médica. (Vitale 2016, Pacchiarotti 2016)


See below the information of this related product:

  • Maternal Depression (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)

See below the information of these related groups:

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.
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Other names

Bipolar Disorder is also known as Maternal Psychotic Disorder. Maternal psychosis, schizophrenia, bipolar disorder. Here it is a list of alternative known names::


Group

Bipolar Disorder belongs to this group or family:

References

  1. Kim H, Yoo J, Han K, Park MJ, Kim HS, Baek J, Jeon HJ. Female reproductive factors are associated with the risk of newly diagnosed bipolar disorder in postmenopausal women. J Psychiatr Res. 2022 Jun 30;153:82-89. Consulted on July 18, 2022 Abstract
  2. Viguera AC, Vanderkruik R, Gaccione P, Caplin PS, Kobylski LA, Freeman MP, Cohen LS. Breastfeeding practices among women taking second-generation antipsychotics: findings from the National Pregnancy Registry for Atypical Antipsychotics. Arch Womens Ment Health. 2022 Apr;25(2):511-516. Consulted on April 7, 2022 Abstract
  3. Sinha SK, Kishore MT, Thippeswamy H, Kommu JVS, Chandra PS. Adverse effects and short-term developmental outcomes of infants exposed to atypical antipsychotics during breastfeeding. Indian J Psychiatry. 2021 Jan-Feb;63(1):52-57. Abstract
  4. Uguz F. A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation. Am J Ther. 2021 Jan-Feb 01;28(1):e118-e126. Abstract
  5. Teodorescu A, Dima L, Popa MA, Moga MA, Bîgiu NF, Ifteni P. Antipsychotics in Postpartum Psychosis. Am J Ther. 2020 Jun 22;28(3):e341-e348. Abstract
  6. Rybakowski J, Cubała WJ, Gałecki P, Rymaszewska J, Samochowiec J, Szulc A, Dudek D. Recommendations of the Polish Psychiatric Association regarding the treatment of affective disorders in women of childbearing age. Part II: Bipolar disorder. Psychiatr Pol. 2019 Apr 30;53(2):263-276. Abstract Full text (link to original source)
  7. Payne JL. Psychopharmacology in Pregnancy and Breastfeeding. Med Clin North Am. 2019 Jul;103(4):629-650. Abstract
  8. McAllister-Williams RH, Baldwin DS, Cantwell R, Easter A, Gilvarry E, Glover V, Green L, Gregoire A, Howard LM, Jones I, Khalifeh H, Lingford-Hughes A, McDonald E, Micali N, Pariante CM, Peters L, Roberts A, Smith NC, Taylor D, Wieck A, Yates LM, Young AH; et al. British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017. J Psychopharmacol. 2017 May;31(5):519-552. Abstract
  9. Uguz F, Sharma V. Mood stabilizers during breastfeeding: a systematic review of the recent literature. Bipolar Disord. 2016 Abstract
  10. Vitale SG, Laganà AS, Muscatello MR, La Rosa VL, Currò V, Pandolfo G, Zoccali RA, Bruno A. Psychopharmacotherapy in Pregnancy and Breastfeeding. Obstet Gynecol Surv. 2016 Dec;71(12):721-733. Abstract
  11. Uguz F. Second-Generation Antipsychotics During the Lactation Period: A Comparative Systematic Review on Infant Safety. Am J Ther. 2016;36(3):244-52. Abstract
  12. Pacchiarotti I, León-Caballero J, Murru A, Verdolini N, Furio MA, Pancheri C, Valentí M, Samalin L, Roigé ES, González-Pinto A, Montes JM, Benabarre A, Crespo JM, de Dios Perrino C, Goikolea JM, Gutiérrez-Rojas L, Carvalho AF, Vieta E. Mood stabilizers and antipsychotics during breastfeeding: Focus on bipolar disorder. Eur Neuropsychopharmacol. 2016 Oct;26(10):1562-78. Abstract
  13. Larsen ER, Damkier P, Pedersen LH, Fenger-Gron J, Mikkelsen RL, Nielsen RE, Linde VJ, Knudsen HE, Skaarup L, Videbech P. Use of psychotropic drugs during pregnancy and breast-feeding. Acta Psychiatr Scand Suppl. 2015 Abstract
  14. Grover S, Avasthi A. Mood stabilizers in pregnancy and lactation. Indian J Psychiatry. 2015 Abstract Full text (link to original source) Full text (in our servers)
  15. Peuskens J, Pani L, Detraux J, De Hert M. The effects of novel and newly approved antipsychotics on serum prolactin levels: a comprehensive review. CNS Drugs. 2014 May;28(5):421-53. Abstract Full text (link to original source)
  16. Xu F, Li Z, Binns C, Bonello M, Austin MP, Sullivan E. Does infant feeding method impact on maternal mental health? Breastfeed Med. 2014 Abstract
  17. Sharma V, Burt VK, Ritchie HL. Bipolar II postpartum depression: Detection, diagnosis, and treatment. Am J Psychiatry. 2009 Abstract Full text (link to original source) Full text (in our servers)
  18. Wakil L, Epperson CN, Gonzalez J, O'Reardon JP, Kim DR. Neonatal outcomes with the use of lamotrigine for bipolar disorder in pregnancy and breastfeeding: a case series and review of the literature. Psychopharmacol Bull. 2009 Abstract
  19. Seyfried LS, Marcus SM. Postpartum mood disorders. Int Rev Psychiatry. 2003 Abstract
  20. Birnbaum CS, Cohen LS, Bailey JW, Grush LR, Robertson LM, Stowe ZN. Serum concentrations of antidepressants and benzodiazepines in nursing infants: A case series. Pediatrics. 1999 Abstract Full text (link to original source)

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