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14 November 2013
Bipolar and pregnant

How physiological changes during pregnancy reduce the effectiveness of bipolar drugs has been revealed for the first time by researchers from Northwestern University.

Around 4 million women in the U.S. have bipolar disorder, with women of childbearing age having the highest prevalence. The new study was published in the American Journal of Psychiatry.

The new findings, showing that pregnancy makes women more vulnerable to bipolar episodes, should help in the prevention of bipolar symptoms during pregnancy, which are risky for both the health of the mother and her unborn child.

The new research shows the blood concentration of the commonly used drug lamotrigine (marketed as Lamictal) decreases in pregnant women. About half of the women in the study had worsening depressive symptoms as their lamotrigine blood levels dropped. The drug levels fall because women have increased metabolism during pregnancy.

"The safety of the fetus is at risk," said lead researcher Crystal Clark. "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."

The study results will help physicians understand how to increase their patients' doses during pregnancy and then reduce them postpartum to avoid toxicity. New guidelines for prescribing the drug for pregnant women with bipolar are included in the study.

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Source: Northwestern University

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