Management of Bipolar II Disorder during Pregnancy and the Postpartum Period

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Verinder Sharma


Management, Bipolar II Disorder, Pregnancy, Postpartum Period


The spectrum of bipolar disorder (BPD) includes BP  I,  BP  II,  and  BP  not  otherwise  specified (NOS).  The latter two conditions  are thought  to have a combined lifetime prevalence of 3.5% compared to a prevalence rate of 1.0% for BP I. Despite  the combined  high  prevalence  of BP II and BP NOS,  surprisingly  little is known  about the course and treatment of these disorders during pregnancy and the postpartum period. Brief  hypomanic   symptoms   occur  in  the early puerperium in as many as 15% of women, and there is preliminary evidence that postpartum depression in some patients may be related to BP II or BP NOS. Yet there is paucity of data on the acute,   and   maintenance    treatment   of   major depressive  episodes  during pregnancy  in women with BP II and BP NOS. And there are no psychopharmacological studies on the acute or maintenance treatment of bipolar postpartum depression   to  guide   clinical   decision   making. Also, there is a lack of screening instruments designed   specifically   for   use   before   or   after delivery  in  women  with  suspected  bipolar disorder. This paper reviews  the current literature on the diagnosis, and treatment of BP II and BP NOS during  pregnancy  and  in  the  postpartum  period and makes recommendations for the detection and treatment of these disorders

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