LITHIUM PREGNANCY

RISK NewsletterDisclaimer: This newsletter, provided by ITIS, is funded by a grant from the Illinois Department of Public Health and supported by Northwestern Memorial Hospital and Northwestern University Medical School. It is for educational purposes only and is meant to summarize the information available at the time of its creation. It should be construed neither as medical advice nor opinion on any specific clinical situation. For more information on a specific clinical situation,or updated information, please consult your health care provider. Affective disorders are classified into two major categories, unipolar and bipolar. Unipolar disorders have recurrent major depressive episodes. Bipolar disorders involve recurrent periods of depression and mania (manic-depressive illness). The latter psychosis tends to be episodic, with a propensity for depression, but also exhibits one or more striking periods of enhanced alertness, great energy, flights of fancy, and other typical symptoms of mania. This RISK||NEWSLETTER will discuss the differences between unipolar and bipolar disorders and then focus on the effects that lithium may have on a pregnancy. Schere, 1973). Nora et al (1974) first described the association of Ebstein's anomaly with antepartum lithium exposure. Ebstein's anomaly is the congenital downward displacement of the tricuspid valve into the right ventricle. In their study of 733 women, there were only 2 women on lithium and both delivered children with Ebstein's anomaly. These results proved to be significant and unlikely due to coincidence, since the incidence of this anomaly is 1 in 20,000. These results suggest that infants of women treated with lithium during pregnancy are at risk for Ebstein's anomaly approximately 400 times greater than the general population.