Lithium
What is it?
Lithium is a mood-stabilising treatment used to treat bipolar disorder, mania, and recurrent depression.
Benefits
What are the benefits of using lithium in pregnancy?
Lithium can be an effective treatment for some mental health disorders, and sometimes works well when other medicines have not been effective. This is important both for a woman’s quality of life, and to ensure that she remains well in preparation for caring for her baby.
Risks
What are the risks of using lithium in pregnancy?
Lithium use in pregnancy may increase the chance of the baby being born with a heart defect. Approximately 1 in every 100 babies born in the UK has a heart defect. This is called the background rate. Some studies suggest that around 2 in every 100 babies exposed in the womb to lithium are born with a heart defect. This still means that the vast majority of babies (98 out of every 100) born to women taking lithium have a normal heart. There is no strong evidence that lithium causes any other problems in pregnancy.
Alternatives
Are there any alternatives to using lithium in pregnancy?
Possibly. Depending on the severity of the illness and whether other medications have been tried in the past, alternative medication can sometimes be used. Additionally, some women, together with their doctor, may decide that treatment can be safely withdrawn during pregnancy.
Women using lithium who are planning a pregnancy or become pregnant should consult their doctor or specialist so that their medication can be reviewed. They should not stop or reduce lithium treatment without medical supervision, as this could put their mental health at risk.
No treatment
What if I prefer not to take medicines during pregnancy?
Women with bipolar affective disorder, mania and depression are at high risk of relapse during pregnancy or in the weeks and months after the baby has been born. Continuing lithium is likely to be the safest option to keep you healthy and enable you to look after your baby. Your doctor will only prescribe medicines when necessary and will be happy to talk to you about any concerns that you might have.
Will I or my baby need extra monitoring?
As part of routine antenatal care, most women will be offered a detailed scan at around 20 weeks of pregnancy to check the baby’s development. Women who have used lithium in early pregnancy will not usually require any extra monitoring of the baby’s development.
If you continue lithium in pregnancy, you may be offered extra blood tests to check your lithium levels. Depending on the results, the dosage may be adjusted, especially in later pregnancy.
Are there any risks to my baby if the father has used lithium?
There is currently no evidence that lithium used by the father around the time of conception can harm the baby.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.