Trastorno bipolar en embarazo y lactancia

Análisis de las pautas de tratamiento según las Guías de Práctica Clínica

  • Belén Rodado León Graduada en Medicina, Universidad de Alcalá
  • Guillermo Lahera Forteza Facultad de Medicina y Ciencias de la Salud UAH
  • Jerónimo Sáiz Ruiz Departamento de Medicina y Especialidades Médicas, Área de Psiquiatría, Universidad de Alcalá. Hospital Ramón y Cajal. CIBERSAM. IRyCis

Resumen

El trastorno bipolar (TB) es una enfermedad psiquiátrica crónica, caracterizada por fluctuaciones del humor, desde la manía hasta la depresión bipolar. Dado que suele debutar en adultos jóvenes, afecta a mujeres en edad fértil y embarazadas. El TB se asocia con mayor riesgo de efectos adversos en el embarazo, incluyendo aquellos relacionados con la medicación y posibles recaídas de la enfermedad. El objetivo de esta revisión sistemática es analizar la bibliografía reciente y de calidad sobre el tratamiento farmacológico del TB. Para ello se realizó una búsqueda sistemática en PubMed de artículos publicados entre 2012 y 2017, seleccionando aquellos de mayor calidad siguiendo los criterios de la guía PRISMA. Los psicotrópicos empleados en el TB, que incluyen principalmente litio, algunos antiepilépticos, antipsicóticos, antidepresivos y benzodiacepinas, se han asociado con efectos adversos tales como malformaciones congénitas, anomalías cardiacas, afectación del neurodesarrollo, síndrome de adaptación neonatal, abortos espontáneos y parto pretérmino, entre otros. Las recomendaciones de las Guías de Práctica Clínica (GPC) deben interpretarse con cautela, ya que tienen grados variables de evidencia y gran parte de los datos disponibles necesitan mayor investigación en futuros estudios. En conclusión, para manejar el TB durante el embarazo y lactancia, se debe utilizar el fármaco con mejor perfil de seguridad, con la mínima dosis eficaz, y en monoterapia si es posible, y es obligado monitorizar estrechamente la evolución de la mujer y de su hijo. Las GPC proporcionan un apoyo apropiado y necesario, pero siempre se debe individualizar el tratamiento

Autor principal

Guillermo Lahera Forteza, Facultad de Medicina y Ciencias de la Salud UAH

Miembro del comité científico de la revista RIECS. Área de conocimiento: Psiquiatría.

Citas

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Publicado
10-12-2018
Cómo citar
RODADO LEÓN, Belén; LAHERA FORTEZA, Guillermo; SÁIZ RUIZ, Jerónimo. Trastorno bipolar en embarazo y lactancia. Revista de Investigación y Educación en Ciencias de la Salud (RIECS), [S.l.], v. 2, n. 2, p. 49 - 62, ene. 1970. ISSN 2530-2787. Disponible en: <https://riecs.es/index.php/riecs/article/view/45>. Fecha de acceso: 10 dic. 2018
Sección
Artículos de Revisión