A 33-year-old woman had been maintained successfully on lithium therapy for two years for a bipolar disorder. Now she planned to became pregnant. Her psychiatrist ordered to stop lithium and to start another medication. Which of the following drugs was most likely prescribed?
A. Carbamazepine B. Valproate C. Quietapine D. Haloperidol E. Clozapine F. Amitriptyline
Quietapine-learning objective: describe the use of atypical antipsychotics for the maintenance
therapy of bipolar disorder during pregnancy.
some anticonvulsants (valproate, lamotigrine, carbamazepine) and some atypical
antipsychotics (aripiprazole, olanzapine, quietapine, risperidone) have become good alternative
and adjunctive treatments to lithium for maintenance therapy of bipolar disorder. among atypical
antipsychotics quietapine has the lowest ratio of umbilical cord to maternal plasma
concentration and does not seem to cause significant teratogenic risk to the fetus. therefore is
a rational choice for maintenance therapy in a pregnant woman with bipolar disorder.
a, b) valproate and carbamazepine are effective in maintenance therapy of bipolar disorder but
are contraindicated during pregnancy because of a substantial teratogenic risk ( both are
classified by fda in the pregnancy risk category d
d, e, f) these drugs have no proven efficacy for maintenance therapy of bipolar disorder.