| Purpose. This paper is a comprehensive review of the literature to determine appropriate treatment for pregnant women with bipolar disorder that is both efficacious and safe for the mother and unborn child.Data sources. Publications were identified by computer searches of OVID, CINAHL and PUB MED.Results. Fifty-two articles published between the years 1999 and 2008 were analyzed for this review. Twenty-seven of these articles were utilized in this paper. Articles were chosen that spoke to both pregnancy and bipolar disorder. Articles were rejected that emphasized the other psychotic disorders.Conclusions. The review of literature chosen for this paper resulted in description of bipolar disorder in pregnancy and a review of treatment options. Optional treatments include pharmacologic, nonpharmacologic, and alternative treatments. Pharmacologic treatments will be discussed in light of risks to the unborn child and mother. Postpartum and lactation will be reviewed. Comprehensive treatment includes caring for the pregnant woman, the unborn child, and for those who comprise her support system.Implications for practice. Treatment of bipolar disorder in pregnancy should be based on the risk-benefit decision making model. Treatment should begin before conception and extend through postpartum. It is imperative the clinician know the patient, the illness, and details about the pregnancy in order to provide optimal treatments.Key words: bipolar disorder, pregnancy, pharmacologic treatment, nonpharmacologic treatment, alternative treatment, risk/benefit, decision making model for planning safe treatment. |
