Abstract
Women with bipolar disorder are at high risk for relapse throughout pregnancy and in the postpartum period, especially when mood stabilizer medication is discontinued. Postpartum disruption of circadian rhythms, immune dysregulation, and abrupt fluctuation of reproductive hormones can precipitate postpartum psychosis, a psychiatric emergency with an increased risk of suicide and a 4% risk of infanticide. Fortunately, effective treatments exist for managing bipolar disorder in pregnancy, with the aim of preventing episode recurrence and maintaining function. Risks associated with psychotropic medication in pregnancy must be balanced against risks of untreated bipolar illness. In this review, we present risk profiles of existing treatments for bipolar disorder in pregnancy and breast-feeding, concluding with key evidence-based resources for clinicians and patients. [ Psychiatr Ann. 2019;49(9):392–398.]
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