L'Information Psychiatrique


Prise en charge du trouble bipolaire chez la femme en âge de procréer Volume 84, issue 2, février 2008

CH Charles Perrens et EA3662, Université Bordeaux 2, CHU Pellegrin, Maternité et Université Bordeaux 2, Equipe d’Accueil EA2381, Université Paris VII, Hall de Biotechnologies, Tour 54, 2 place Jussieu, 75251 Paris Cedex 05

Pregnancy does not protect against bipolar disease.Indeed, treatment reduction or suppression increases the risk of relapse, some mood stabilizers can be teratogenic, and pregnancy increases the metabolic risk of atypical antipsychotics. Medical management of a bipolar pregnant woman requires the coordination of several participants, including specialists in perinatality and mental health and particularly a follow up in maternity of level 2 or 3. Generally speaking, the use of some anticonvulsants in bipolar women can reduce contraceptive efficacy or increase their thromboembolic risk. Therefore, it is the bipolar fertile woman who needs special medical attention. Here, we try to define the main axes of their medical management, based on a bibliographic research and the recommendations of American Psychiatric Association guidelines, CRAT and of expert consensus.