Magazine article Clinical Psychiatry News

Pregnancy Often Triggers Bipolar Relapse, Studies Show

Magazine article Clinical Psychiatry News

Pregnancy Often Triggers Bipolar Relapse, Studies Show

Article excerpt

PITTSBURGH -- Pregnancy can trigger a relapse in women with bipolar disorder, especially if they stop their mood-stabilizing treatment.

Although data from several studies are conflicting, a prospective study showed that about two-thirds of women with a history of bipolar disorder had a relapse during pregnancy, Adele C. Viguera, M.D., said at the Sixth International Conference on Bipolar Disorder.

In that study, about half of the women had relapsed before their 18th week of pregnancy. Relapse was even more rapid in the postpartum period, with about half of the women studied having a return of their bipolar disorder within 6 weeks after delivery, said Dr. Viguera, of the department of psychiatry at Massachusetts General Hospital in Boston.

Results from a separate study, led by Dr. Viguera and first reported 2 years ago, showed that the majority of bipolar recurrences during pregnancy or post partum involve either major depressive episodes or mixed states.

A major factor linked with recurrences is discontinuation of mood-stabilizing treatment, especially an abrupt stop. In Dr. Viguera's study, which involved 82 women, the relapse rate among the women who stopped their mood-stabilizing medication was 75%, compared with a 35% relapse rate among women who continued their treatment.

Another important determinant of relapse is whether affective illness occurs during pregnancy. In Dr. Viguera's study, a total of 61% of the women had a postpartum relapse. More than 80% of the women with relapses had affective illness in pregnancy. …

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