What is it about?

Lithium is a moodstabilizer for the treatment and prevention of mania and depression in people with bipolar disorder. An important consideration is how safe this medication is when taken during pregnancy. Several decades ago a study (with poor methodology) found that lithium can cause congenital anomalies of the heart in children, if their mother takes this drug in the first three months of pregnancy. It is now thought that the risk of cardiac anomalies is small and a recent study suggests that it is probably related to higher doses. A recent large study has also examined in detail how the blood concentration of lithium changes as preganncy progresses.

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Why is it important?

These findings mean that lithium is likely to be used more often in pregnancy. This is important because it has been realized in recent years that lithium has advantages over other mood stabilizers and is now considered the preferred long-term treatment for people with bipolar disorder who are tolerating it well.

Perspectives

It is always difficult for women and their doctors to make a decision about taking medication in pregnancy and am very pleased that these recent findings have reduced the worries about one important treatment for bipolar disorder.

Angelika Wieck
Greater Manchester West Mental Health NHS Foundation Trust

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This page is a summary of: Prevention of bipolar episodes with lithium in the perinatal period, The British Journal of Psychiatry, July 2017, Cambridge University Press, DOI: 10.1192/bjp.bp.116.193508.
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