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首页> 外文期刊>The journal of clinical psychiatry >The use of mood stabilizers during breastfeeding.
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The use of mood stabilizers during breastfeeding.

机译：母乳喂养期间使用情绪稳定剂。

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The literature and majority of professional organizations endorse breastfeeding as a means to provide a number of health benefits to both mother and child. Notably, the postpartum period heralds an increased vulnerability for both new onset and symptom worsening of neuropsychiatric disorders, particularly bipolar disorder in women. While pharmacologic treatment is important for these patients, many physicians have been hesitant to prescribe medication for women who choose to breast-feed, despite the fact that a variety of medical illnesses are routinely treated in breastfeeding women (e.g., epilepsy, infection, allergies, and migraine) and that nursing infants may also directly receive medications for colic and reflux. To date, all psychotropic medications studied enter human breast milk, and many of these medications have undergone detailed investigations. While breastfeeding may complicate pharmacotherapy, it does not preclude it. There are limited scientifically derived guidelines in the treatment of women who choose to breast-feed. The pharmacokinetic properties and potential impact of infant exposure to mood stabilizers must be considered in the decision to breast-feed infants born to mothers receiving pharmacologic treatment for bipolar disorder. Past practices and methodologies for determining continuation of treatment are discussed in this article, as well as the current data for newer categories of drugs being used to treat bipolar disorder and their indications during pregnancy and breastfeeding. Treating pregnant women with neuropsychiatric illnesses in their childbearing years who are breastfeeding involves a thorough risk:benefit analysis to determine the relative safety of pharmacologic therapy. Familiarity with the extant literature and its limitations and practical considerations will enable optimizing treatment plans that maintain maternal mental health, minimize nursing infant exposures, and provide infant monitoring.
机译：文献和大多数专业组织都认可母乳喂养，以此为母婴提供许多健康益处。值得注意的是，产后时期预示着神经精神疾病，特别是女性双相情感障碍的新发和症状恶化的脆弱性增加。尽管药物治疗对这些患者很重要，但许多医生仍不愿为选择母乳喂养的妇女开药，尽管事实上，母乳喂养的妇女通常会治疗多种疾病（例如，癫痫，感染，过敏，和偏头痛），并且哺乳婴儿也可以直接接受肠绞痛和反流药物。迄今为止，所有研究的精神药物都进入了人类母乳，并且其中许多药物都经过了详细的研究。虽然母乳喂养可能会使药物治疗复杂化，但并不排除这种情况。在选择母乳喂养的妇女的治疗中，从科学上得出的指导原则是有限的。在决定接受双相情感障碍药物治疗的母亲所生的母乳喂养婴儿的决定中，必须考虑婴儿接触情绪稳定剂的药代动力学特性和潜在影响。本文讨论了确定继续治疗的过去做法和方法，并讨论了用于治疗躁郁症的新型药物及其在怀孕和母乳喂养期间的适应症的最新数据。在育龄期接受母乳喂养的神经精神疾病孕妇的治疗涉及彻底的风险：获益分析，以确定药物治疗的相对安全性。熟悉现有文献及其局限性和实际考虑因素将有助于优化治疗计划，以保持孕产妇的心理健康，最大程度地减少婴儿的护理暴露并提供婴儿监护。

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