Management of bipolar disorder over the perinatal period.

BACKGROUND Women with bipolar disorder have a high risk of relapse following childbirth. The risk of relapse can be reduced by mood stabilisers, but they are potentially harmful to the developing fetus. OBJECTIVE The objective of this article is to provide an up-to-date review of the strategies for managing women with bipolar disorder over the perinatal period. DISCUSSION Discussing the risks of taking mood stabilisers or having a medication-free pregnancy is essential for women with bipolar disorder. The latter, with careful monitoring, is suggested for women with less severe illness and good supports. Full or partial prophylaxis with a mood stabiliser is recommended for women at higher risk of relapse. Careful monitoring during pregnancy, psychosocial interventions and planning for the postnatal period will aid in preventing bipolar disorder relapse. The general practitioner is ideally placed to take a key management role in liaising with the obstetric and mental health teams, and planning for the postnatal period.