Pregnancy moods
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During lactation, use of valproate and LTG is reported to be safe. Data for lamotrigine (LTG) appears to be more favorable than other antiepileptics. This group is for anyone struggling with the challenges and mood changes that you may be feeling while trying to get pregnant, pregnancy and/or after birth. Similarly use of carbamazepine in first trimester is associated with higher risk of major congenital malformation and its use in first trimester is contraindicated. When you cry over sappy advertisements, realize it's just business as usual during pregnancy. Use of valproate during first trimester is associated with major malformation and long-term sequalae in the form of developmental delay, lower intelligence quotient, and higher risk of development of autism spectrum disorder. Be flexible and patient and liberate yourself from unreasonable expectations. Among the various mood stabilizers, use of lithium during the second and third trimester appears to be safe. Whenever patient is on psychotropic medication, close and intensive monitoring should be done. The choice of drug should depend on the balance between safety and efficacy profile. The treating clinicians have to take into account various factors like current mental state, longitudinal history of the patient, past history of relapse while off medication, response to medication, time of pregnancy at which patient presents to the clinician, etc. Management of bipolar during pregnancy and postpartum is very challenging.