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Mood stabilizers and antipsychotics during breastfeeding: Focus on bipolar disorder
- Source :
- European Neuropsychopharmacology. 26:1562-1578
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Breast milk is considered the best source of nutrients and provides much better protection than immune modified milk. However, the postpartum period is a phase of increased risk for all women to experience psychiatric symptoms and recurrences or new episodes of bipolar disorder (BD), especially in those who have discontinued treatment. This is a systematic review of the risks and benefits of mood stabilizers and antipsychotics during breastfeeding as they relate to the health and well-being of mothers and their infants. Evidence-based treatment advice for women with BD during lactation is also provided. This systematic review has been conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. We included studies examining the exposure and the effects of antipsychotics and mood stabilizers used to treat BD on infants during breastfeeding clearly reporting the estimated amount of drug or effects on infants. The final selection included 56 studies. The available data supports the use of lithium as a possible treatment option during breastfeeding. Carbamazepine and valproic acid are also considered relatively safe. Lamotrigine can be used but at the lowest doses and considered for individual cases. Among the antipsychotics, quetiapine and olanzapine should be considered as first-line treatment options. Risperidone may be compatible with breastfeeding under medical supervision. Clozapine and amisulpiride are currently contraindicated. Long-term outcome studies evaluating the infant׳s health and psychosocial and cognitive functioning are needed.
- Subjects :
- Adult
medicine.medical_specialty
Bipolar Disorder
Breastfeeding
Lamotrigine
03 medical and health sciences
0302 clinical medicine
Antimanic Agents
medicine
Humans
Pharmacology (medical)
Bipolar disorder
Psychiatry
Biological Psychiatry
Clozapine
Pharmacology
Milk, Human
business.industry
Postpartum Period
Infant, Newborn
medicine.disease
030227 psychiatry
Psychiatry and Mental health
Breast Feeding
Mood
Neurology
Quetiapine
Female
Neurology (clinical)
business
Breast feeding
030217 neurology & neurosurgery
Postpartum period
Antipsychotic Agents
medicine.drug
Subjects
Details
- ISSN :
- 0924977X
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- European Neuropsychopharmacology
- Accession number :
- edsair.doi.dedup.....88108674477371feb37dd03948045d75