Komaroff Ariana
Columbia University School of Nursing, 560 W 168 Street, New York, NY 10032, United States of America.
Case Rep Womens Health. 2021 Mar 13;30:e00308. doi: 10.1016/j.crwh.2021.e00308. eCollection 2021 Apr.
Bipolar disorder is a chronic and severe psychiatric illness affecting many patients during their childbearing years. Bipolar disorder is often managed with aripiprazole, a generally well tolerated second-generation antipsychotic medication. Published data regarding its safety profile are reassuring and aripiprazole is prescribed during pregnancy, postpartum and during lactation. Pregnancy and the postpartum period represent times of increased vulnerability for patients with bipolar disorder, especially those who are untreated, highlighting the need for medical management. However, aripiprazole may interfere with human milk production. Currently, there is limited evidence to understand lactation failure in patients who take aripiprazole. This case reinforces the need for shared decision making regarding the potential impact on lactation when aripiprazole is being considered for the pregnant patient with bipolar disorder.
双相情感障碍是一种慢性重症精神疾病，影响着许多处于育龄期的患者。双相情感障碍通常使用阿立哌唑进行治疗，阿立哌唑是一种耐受性普遍良好的第二代抗精神病药物。已发表的关于其安全性的资料令人安心，阿立哌唑可在孕期、产后及哺乳期使用。怀孕和产后阶段，双相情感障碍患者，尤其是未接受治疗的患者，更易出现问题，这凸显了医疗管理的必要性。然而，阿立哌唑可能会干扰母乳分泌。目前，对于服用阿立哌唑的患者出现泌乳失败的情况，了解相关情况的证据有限。该病例强调，对于患有双相情感障碍的孕妇考虑使用阿立哌唑时，需要就其对泌乳的潜在影响进行共同决策。
