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Women with bipolar disorder or histories of postpartum psychosis are at high risk for repeat episodes during subsequent pregnancies. Investigators in the Netherlands studied rates of exacerbation among 41 pregnant bipolar patients with or without ongoing treatment and rates of repeat episodes among 29 pregnant women with no bipolar illness but with prior postpartum psychosis, who initiated or declined prophylaxis immediately postpartum (mean postpartum follow-up, 12.6 weeks).
The recommended treatment was lithium, but alternative mood stabilizers or antipsychotics were allowed. Postpartum patients were encouraged to not breast-feed. To ensure sufficient sleep, they were encouraged to stay on the hospital inpatient service for the first week,…