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Bipolar disorder - Management
How should I manage a woman with bipolar disorder who is planning a pregnancy?
- Refer the woman to a psychiatrist for an assessment and discussion of drug treatment.
- Explain to the woman that the psychiatrist may advise her to:
- Stop drug treatment prior to trying to conceive, and to remain off it throughout the pregnancy.
- Stop drug treatment prior to conception, and to restart it either after the first trimester or immediately after birth.
- Remain on her current drug treatment throughout conception, pregnancy, and birth.
- Switch to another drug treatment prior to attempting to conceive.
- Explain that the strategy which is chosen will depend on her wishes, and on the advice of the medical team who need to balance the risks of undertreatment (e.g. relapse) with the risk of harming the unborn child by remaining on drug treatment.
- Give general pre-conception advice (e.g. smoking and alcohol consumption), and prescribe folic acid.
In depth
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