Evidence map›Paper›PMID 40593436›Full record

ReviewCNS drugs2025

Management of Bipolar Disorder in Pregnancy and Postpartum: A Clinicians' Guide.

Veerle Bergink, Mariella Suleiman, Mary-Anne Hennen, Thalia Robakis

Erratum issuedAbstract readReview
In one paragraph

Review in CNS drugs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Veerle BerginkDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Room L4-34, New York, NY, 10029, USA. Veerle.bergink@mssm.edu.ORCID 0009-0003-4495-4762
Mariella SuleimanDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Room L4-34, New York, NY, 10029, USA.ORCID 0000-0001-8414-8843
Mary-Anne HennenDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Room L4-34, New York, NY, 10029, USA.ORCID 0000-0002-2055-9368
Thalia RobakisDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Room L4-34, New York, NY, 10029, USA.ORCID 0000-0003-2919-2555

Funding

Relapse risk after Discontinuation of Antidepressants during Pregnancy (R-DAP study)R01MH122869 · NIMH · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI Veerle Bergink · 2020 to 2026
$4.3M
Developmental effects of antenatal exposure to antipsychoticsR01HD111117 · NICHD · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI THALIA K ROBAKIS · 2023 to 2026
$2.5M
NICHD NIH HHS R01 HD111117NIMH NIH HHS R01HD111117NIMH NIH HHS R01 MH122869NIMH NIH HHS R01MH122869
6 · The paper itself

Abstract

Medication management in women with bipolar disorder (BD) in the perinatal period is challenging, given that many patients taper or stop medication during pregnancy, and the postpartum period is an extremely high-risk period for relapse. The objective of this narrative review was to investigate the perinatal efficacy as well as potential adverse effects on the child of common treatments for bipolar disorder. These treatments include lithium, lamotrigine, other antiepileptics, quetiapine, olanzapine, aripiprazole, other antipsychotics, antidepressants, benzodiazepines, Z-drugs, and other sleep medication. Despite the worldwide decline in lithium use, it remains the gold standard for acute and maintenance treatment of BD, and we continue to advise its use in women of reproductive age. In contrast, medications with a high risk for teratogenicity such as valproate and carbamazepine should be avoided in women of childbearing potential. Women with bipolar disorder are at very high risk of relapse after delivery, but this risk is more than twofold lower with adequate pharmacological prophylaxis. We advise to make a written perinatal bipolar relapse prevention plan in collaboration with the patient, family, and healthcare professionals, which includes a description of: (1) maintenance treatment during pregnancy, (2) preferred mode of delivery, (3) medication immediately after delivery and the first months postpartum for relapse prevention, (4) preferred plan for feeding (breast-feeding versus bottle-feeding), (5) strategies to assist women in ensuring adequate sleep and stable circadian rhythm in the first weeks after delivery, and (6) how to recognize the first symptoms of relapse and which intervention strategies to take.

Indexed as

Antimanic AgentsBipolar DisorderPregnancy ComplicationsAnticonvulsantsAntipsychotic AgentsFemaleHumansPostpartum PeriodPregnancyAnticonvulsantsAntimanic AgentsAntipsychotic Agents

Identifiers

PMID40593436
PMCPMC12532674

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.