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01-04-2010 | Short Communication

Perinatal use of anticonvulsants: differences in attitudes and recommendations among neurologists and psychiatrists

Authors: Adele C. Viguera, Lee S. Cohen, Theodore Whitfield, Alison M. Reminick, Edward Bromfield, Ross J. Baldessarini

Published in: Archives of Women's Mental Health | Issue 2/2010

Abstract

We surveyed opinions and recommendations about perinatal anticonvulsant (AC) treatment among 166 neurologists (n = 88) and psychiatrists (n = 78) practicing in Massachusetts. They were similar in the recommendation of routinely informing patients of potential teratogenic risks of ACs and avoiding valproate during pregnancy. Neurologists were more likely to encourage pregnancy and nursing during AC-use than psychiatrists, and psychiatrist were more cautious regarding perinatal safety, citing potential neurobehavioral risks and complications of breastfeeding. These observations indicate substantial differences in opinions between psychiatrists and neurologists regarding AC use during pregnancy.

Baldessarini RJ, Leahy L, Arcona S, Gause D, Zhang W, Hennen J (2007) Patterns of psychotropic drug prescription for US patients with diagnoses of bipolar disorders. Psychiatr Serv 58(1):85–91CrossRefPubMed

Bowden CL (2009) Anticonvulsants in bipolar disorders: current research and practice and future directions. Bipolar Disord 11(Suppl 2):20–33CrossRefPubMed

Harden CL, Hopp J, Ting TY, Pennell PB, French JA, Allen Hauser W, Wiebe S, Gronseth GS, Thurman D, Meador KJ, Koppel BS, Kaplan PW, Robinson JN, Gidal B, Hovinga CA, Wilner AN, Vazquez B, Holmes L, Krumholz A, Finnell R, Le Guen C, American Academy of Neurology, American Epilepsy Society (2009) Management issues for women with epilepsy-focus on pregnancy (an evidence-based review): obstetrical complications and change in seizure frequency. Epilepsia 50(5):1229–1236CrossRefPubMed

Meador KJ, Penovich P, Baker GA, Pennell PB, Bromfield E, Pack A, Liporace JD, Sam M, Kalayjian LA, Thurman DJ, Moore E, Loring DW, for the NEAD Study Group (2009) Antiepileptic drug use in women of childbearing age. Epilepsy Behav 15(3):339–343CrossRefPubMed

Melvin CL, Carey TS, Goodman F, Oldham JM, Williams JW Jr, Ranney LM (2008) Effectiveness of antiepileptic drugs for the treatment of bipolar disorder: findings from a systematic review. J Psychiatr Pract 14(Suppl 1):9–14CrossRefPubMed

Newport DJ, Stowe ZN, Nemeroff CB (2002) Parental depression: animal models of an adverse life event. Am J Psychiatry 159(8):1265–1283CrossRefPubMed

Talge NM, Neal C, Glover V (2007) Early stress, translational research and prevention science network: fetal and neonatal experience on child and adolescent mental health. Antenatal maternal stress and long-term effects on child neurodevelopment: how and why? J Child Psychol Psychiatry 48(3–4):245–261CrossRefPubMed

Viguera AC, Nonacs R, Cohen LS, Tondo L, Murray A, Baldessarini RJ (2000) Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance. Am J Psychiatry 157(2):179–184CrossRefPubMed

Viguera AC, Cohen LS, Bouffard S, Whitfield TH, Baldessarini RJ (2002) Reproductive decisions by women with bipolar disorder after pre-pregnancy psychiatric consultation. Am J Psychiatry 159(12):2102–2104CrossRefPubMed

Viguera AC, Whitfield T, Baldessarini RJ, Newport DJ, Stowe Z, Reminick A, Zurick A, Cohen LS (2007) Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood stabilizer discontinuation. Am J Psychiatry 164(12):1817–1824CrossRefPubMed

Wieck A, Rao S, Sein K, Haddad PM (2007) A survey of antiepileptic prescribing to women of childbearing potential in psychiatry. Arch Womens Ment Health 10(2):83–85CrossRefPubMed

Yonkers KA, Wisner KL, Stowe Z, Leibenluft E, Cohen L, Miller L, Manber R, Viguera A, Suppes T, Altshuler L (2004) Management of bipolar disorder during pregnancy and the postpartum period. Am J Psychiatry 161(4):608–620CrossRefPubMed

Title: Perinatal use of anticonvulsants: differences in attitudes and recommendations among neurologists and psychiatrists
Authors: Adele C. Viguera
Lee S. Cohen
Theodore Whitfield
Alison M. Reminick
Edward Bromfield
Ross J. Baldessarini
Publication date: 01-04-2010
Publisher: Springer Vienna
Published in: Archives of Women's Mental Health / Issue 2/2010
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI: https://doi.org/10.1007/s00737-009-0130-1

At a glance: The STEP trials

Springer Medicine

Perinatal use of anticonvulsants: differences in attitudes and recommendations among neurologists and psychiatrists

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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