User:Bleuie/Lithium (Other copy)

Pregnancy and breastfeeding:

Lithium is a teratogen, which can cause birth defects in a small number of newborns. Case reports and several retrospective studies have demonstrated possible increases in the rate of a congenital heart defects including Ebstein's anomaly if taken during pregnancy. Teratogenicity is affected by trimester and dose of Lithium. Most significantly affecting first trimester cardiac development with greater effects at higher doses.

As the risks of stopping Lithium can be significant, patients are sometimes recommended to stay on this medicine while pregnant. Careful weighing of the risks and benefits should be made in consultation with a psychiatric physician.

For patients who are exposed to lithium, or plan to stay on the medication throughout their pregnancy, fetal echocardiography is routinely performed to monitor for cardiac anomalies.

While Lithium is typically the most effective treatment, possible alternatives to Lithium include Lamotrigine and Second generation Antipsychotics for the treatment of acute bipolar depression or for the management of bipolar patients with normal mood during pregnancy.

While only small amounts of Lithium are transmitted to the infant in breastmilk, there is limited data on the safety of Breastfeeding while on Lithium. Medical evaluation and monitoring of infants consuming breastmilk during maternal prescription may be indicated.