Krüger Stephanie
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité Campus Mitte, Universitätsmedizin Berlin, Berlin.
Ther Umsch. 2009 Jun;66(6):475-84. doi: 10.1024/0040-5930.66.6.475.
Pregnancy and the postpartum are times of increased risk for women with bipolar disorder to develop mood episodes, especially depressions that may require pharmacotherapy. If mood stabilizing agents are discontinued prior or due to pregnancy, the risk for relapse increases dramatically. On the other hand, there is no psychotropic drug that is completely risk-free for the unborn. Some mood stabilizing medications are teratogenic, others can cause severe perinatal complications. Thus, the decision whether to treat the pregnant women with psychotropic drugs is difficult to make. In this paper, the reproductive risks of mood stabilizing agents, antidepressants, neuroleptics and benzodiazepines for the fetus are reviewed. During the postpartum period severe mood disorders can occur. The signs and symptoms of these disorders are reviewed and therapeutic strategies are discussed.
对于患有双相情感障碍的女性来说，怀孕和产后是出现情绪发作风险增加的时期，尤其是可能需要药物治疗的抑郁症。如果在怀孕前或因怀孕而停用心境稳定剂，复发风险会急剧增加。另一方面，没有一种精神药物对未出生的胎儿是完全无风险的。一些心境稳定剂具有致畸性，其他药物可能导致严重的围产期并发症。因此，决定是否用精神药物治疗孕妇是很难做出的。本文综述了心境稳定剂、抗抑郁药、抗精神病药和苯二氮䓬类药物对胎儿的生殖风险。在产后期间可能会发生严重的情绪障碍。本文对这些障碍的体征和症状进行了综述，并讨论了治疗策略。
