Mood and Anxiety Disorders During Pregnancy and Postpartum

294 Pages·2005·1.18 MB·English

by  Cohen Lee S

Mood and
Anxiety Disorders
During Pregnancy
and Postpartum
Review of Psychiatry Series
John M. Oldham, M.D., M.S.
Michelle B. Riba, M.D., M.S.
Series Editors
Mood and
Anxiety Disorders
During Pregnancy
and Postpartum
EDITED BY
Lee S. Cohen, M.D.
Ruta M. Nonacs, M.D., Ph.D.
V O L U M E
R E V I E W
OF
PSYCHIATRY 24
No. 4
Washington, DC
London, England
Note:
The authors have worked to ensure that all information in this book is accurate at
the time of publication and consistent with general psychiatric and medical
standards, and that information concerning drug dosages, schedules, and routes
of administration is accurate at the time of publication and consistent with
standards set by the U.S. Food and Drug Administration and the general medical
community. As medical research and practice continue to advance, however,
therapeutic standards may change. Moreover, specific situations may require a
specific therapeutic response not included in this book. For these reasons and
because human and mechanical errors sometimes occur, we recommend that
readers follow the advice of physicians directly involved in their care or the care
of a member of their family.
Books published by American Psychiatric Publishing, Inc., represent the views
and opinions of the individual authors and do not necessarily represent the
policies and opinions of APPI or the American Psychiatric Association.
Copyright © 2005 American Psychiatric Publishing, Inc.
ALL RIGHTS RESERVED
Manufactured in the United States of America on acid-free paper
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The correct citation for this book is
Cohen, Lee S., Nonacs, Ruta M. (editors): Mood and Anxiety Disorders During
Pregnancy and Postpartum (Review of Psychiatry Series, Volume 24, Number 4;
Oldham JM and Riba MB, series editors). Washington, DC, American
Psychiatric Publishing, 2005
Library of Congress Cataloging-in-Publication Data
Mood and anxiety disorders during pregnancy and postpartum / edited by Lee S.
Cohen, Ruta M. Nonacs.—1st ed.
p. ; cm.—(Review of psychiatry series ; v. 24, 4)
Includes bibliographical references and index.
ISBN 1-58562-225-7 (pbk. : alk. paper)
1. Mental illness in pregnancy. 2. Postpartum depression. 3. Affective disorders.
4. Anxiety in women. I. Cohen, Lee S. II. Nonacs, Ruta. III. Series.
[DNLM: 1. Anxiety Disorders—Pregnancy. 2. Mood Disorders—Pregnancy.
3. Depression, Postpartum. 4. Postpartum Period—psychology. WQ 240 M817
2005]
RG588.M66 2005
618.7′6—dc22
2005004568
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Contents
Contributors
ix
Introduction to the Review of Psychiatry Series
xi
John M. Oldham, M.D., M.S., and
Michelle B. Riba, M.D., M.S.
Preface
xv
Lee S. Cohen, M.D., and Ruta M. Nonacs, M.D., Ph.D.
Chapter 1
Course of Psychiatric Illness During
Pregnancy and the Postpartum
1
Laura Fagioli Petrillo, M.D., Ruta M. Nonacs, M.D., Ph.D.,
Adele C. Viguera, M.D., and Lee S. Cohen, M.D.
Unipolar Depression
2
Bipolar Disorder
4
Anxiety Disorders
5
Psychotic Disorders
8
Risks of Untreated Illness in the Mother
9
Conclusion
10
References
11
Chapter 2
Diagnosis and Treatment of Mood and
Anxiety Disorders in Pregnancy
17
Ruta M. Nonacs, M.D., Ph.D., Lee S. Cohen, M.D.,
Adele C. Viguera, M.D., and Juliana Mogielnicki, B.A.
Prevalence of Mood and Anxiety Disorders
During Pregnancy
19
Risks of Untreated Maternal Illness During Pregnancy
20
Treatment of Mood Disorders During Pregnancy
22
Treatment of Anxiety Disorders During Pregnancy
36
General Guidelines for Treatment of Mood and
Anxiety Disorders During Pregnancy
39
Conclusion
41
References
42
Chapter 3
Management of Bipolar Disorder During
Pregnancy and the Postpartum Period:
Weighing the Risks and Benefits
53
Adele C. Viguera, M.D., Lee S. Cohen, M.D.,
Ruta M. Nonacs, M.D., Ph.D., and Ross J. Baldessarini, M.D.
Risk and Course of Bipolar Disorder During Pregnancy 54
Risk and Course of Bipolar Disorder During the
Postpartum Period
56
Potential Risks of Pharmacotherapy During Pregnancy
58
Fetal Risks Associated With
Mood-Stabilizing Agents
60
Treatment Planning for the Pregnant Patient
With Bipolar Disorder
65
Treatment Planning for the Patient With
Bipolar Disorder in the Postpartum Period
69
Conclusion
70
References
70
Chapter 4
Postpartum Mood Disorders
77
Ruta M. Nonacs, M.D., Ph.D.