Risks to Mother and Fetus May Be Reduced

1
Risks to Mother and Fetus May Be Reduced

• Prenatal counseling at least 3 months before
  conception
• Periconceptional use of multivitamins with folate
• Treatment during pregnancy should be avoided if
  clinically feasible
• Particularly during the first trimester
• Monotherapy is preferable
• Higher risk of congenital malformation associated
  with combination therapy
• If treatment is pursued, it is important to treat
  with minimal effective dose
• Minimal effective dose should be estimated by
  using lowest dose that has historically kept
  patient stable and well
• ECT may be used for immediate stabilization
• More than 300 reports of ECT used during
  pregnancy with no clear evidence of teratogenic
  effects

Burt VK et al. Bipolar Disord. 200462-13. Iqbal
MM et al. South Med J. 200194304-322.