Maintain euthymia and prevent mood episodes in pregnant and postpartum women with bipolar disorder

The pharmacological management of bipolar disorder (BD) in pregnancy and postpartum is complex and requires careful consideration of both maternal and foetal/neonatal health. The goal of therapy is to achieve euthymia and prevent future mood episodes whilst minimising risks of adverse foetal/neonatal outcomes. Treatment options during pregnancy and the postpartum period include lithium and lamotrigine as mood stabilisers. Antipsychotics also play a key role in the treatment of acute mania and maintenance treatment of BD. Antidepressants can be used as adjunctive therapy for bipolar depression in patients who are resistant to alternative medicines. Sleep preservation is also essential in preventing bipolar episode-relapse during pregnancy and especially during the postpartum period.