Effect of optimized treatment on the postpartum recurrence in women with bipolar I disorder: A case series

Abstract

Background

Women with bipolar I disorder are at a high risk of recurrence postpartum. This case series describes the postpartum course of bipolar I disorder among women receiving optimized treatment aimed specifically at the prevention of mania.

Methods

Clinical records of 12 pregnant females with bipolar I disorder who were seen consecutively at a perinatal clinic between 2020 and 2023 were reviewed to assess the effect of treatment including psychoeducation, good sleep hygiene, avoidance of antidepressants, and use of sedating atypical antipsychotics on postpartum recurrence.

Results

All except one patient had been hospitalized for bipolar disorder. The mean follow-up period was 56 ± 73 weeks postpartum. Only two patients (16.7 %) had a relapse (both depression) during the postpartum period. No one required psychiatric hospitalization.

Limitations

Small sample size, retrospective design, and lack of comparison group.

Conclusion

Combining psychoeducation, social rhythm therapy, and targeted pharmacotherapy may be effective in the prevention of postpartum recurrence in women with bipolar I disorder.