Bipolar disorder can make daily life more of a challenge than it already is. The only person I knew who was Bipolar was a friend in high school. As long as she was on her meds, she was able to cope with the debilitating mood swings, but when she wasn’t taking them it seemed like she was on an emotional rollercoaster non-stop.

Bipolar disorder can unfortunately become even worse during pregnancy because the typical medication used to treat the disorder doesn’t seem to work quite as well. You can imagine how stressful pregnancy can become when your body is already undergoing immense changes on top of having to cope with a serious mood disorder. New research from Northwestern Medicine has investigated how physiological changes during pregnancy reduce the effects of a commonly used drug to treat bipolar disorder in order to help women with Bipolar disorder experience pregnancy more comfortably.

The research, one of the first of its kind, says that women with Bipolar disorder are often unaware of the side effects that can come with pregnancy. In addition to this, their physicians are also commonly unaware that bipolar medication needs to be adjusted during pregnancy to prevent symptoms from returning during and after pregnancy. This is often because there is little information or research to help guide dosing requirements during pregnancy.

In the U.S. alone, it’s estimated that 4.4 million women have Bipolar disorder and a majority of them are childbearing age. Among these women, those taking lamotrigine may experience worsening depressive symptoms during pregnancy because the concentration of the drug decreases due to an increase in their metabolism.

"Now physicians change the dose of the drug in response to women's symptoms worsening," said lead investigator Dr. Crystal Clark, an assistant professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and a psychiatrist at Northwestern Memorial Hospital. "We need to optimize their medication dosing so they stay well."

The researchers hope that the new study will help physicians become more aware of the need to increase their patient’s doses while they are pregnant and then reduce the dose again after pregnancy to avoid toxicity. The research also included guidelines for prescribing the correct dose during pregnancy.

"The safety of the fetus is at risk," Clark said. "Pregnant women that are depressed are less likely to take care of themselves which often leads to poor nutrition, lack of compliance with prenatal care and isolation from family and friends. It has also been linked to premature births and babies with low birth weights among other poor birth outcomes."

Source: Northwestern University (2013, November 1). Bipolar and pregnant. ScienceDaily.

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