Tratamiento del trastorno afectivo bipolar en el embarazo

Abstract

A number of factors must be evaluated in order to determine the safety of any medication that is being considered for use during pregnancy. All psychotropic medications diffuse readily across the placenta. No psychotropic medication has been approved by the Food and Drug Administration (FDA) for use during the pregnancy, and pregnant women have traditionally been excluded from pharmacologic research. Numerous studies have shown a high relapse rate in psychiatric patient during the pregnancy whose medications were discontinued. When deciding whether or not to treat a psychiatric patient during the pregnancy, the guiding principle is to weigh the risks of fetal exposure to a psychotropic medication against the risks to both the mother and fetus of not treating a psychiatric illness. Patients with bipolar disorder are at significant risk of relapse if untreated, particularly following abrupt discontinuation of lithium. Untreated bipolar illness with recurrence of mania may result in progression of the disorder. Another risk is disease chronicity and treatment resistance.