Viguera A C, Cohen L S
Perinatal and Reproductive Psychiatry Research Program, Massachusetts General Hospital, Boston 02114, USA.
Psychopharmacol Bull. 1998;34(3):339-46.
Although the postpartum period has typically been considered a period of risk for relapse of bipolar disorder, systematic data regarding the course of bipolar disorder during pregnancy is essentially unknown. The management of bipolar women who plan to conceive or who are pregnant poses significant challenges for clinicians who care for these patients. Recent data suggest that pregnancy is not protective and the risk for relapse after lithium discontinuation is similar in pregnant and nonpregnant women with 50 percent relapsing within 6 months. This article reviews the major clinical dilemmas in managing pregnant bipolar patients and recent data on the course of bipolar disorder during pregnancy. Treatment guidelines are presented.
尽管产后时期通常被认为是双相情感障碍复发的风险期，但关于双相情感障碍在孕期病程的系统性数据基本上还不为人知。对于照料这些患者的临床医生而言，计划怀孕或已怀孕的双相情感障碍女性的管理带来了重大挑战。近期数据表明，怀孕并无保护作用，停用锂盐后复发风险在怀孕和未怀孕的女性中相似，50%的患者在6个月内复发。本文综述了管理孕期双相情感障碍患者时的主要临床困境以及双相情感障碍孕期病程的近期数据，并给出了治疗指南。
