After all, is lithium a relevant teratogen?

• Autor(a) principal: Cantilino , Amaury
• Data de Publicação: 2022
• Outros Autores: Rennó Jr , Joel, Ribeiro, Hewdy Lobo, Cavalsan, Juliana Pires, Rocha, Renan
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Debates em Psiquiatria (Online)
• Texto Completo: https://revistardp.org.br/revista/article/view/319
• topic: lítio; gravidez; teratogenicidade; lithium; pregnancy; teratogenesis

A major concern brought on by bipolar patients of reproductive age is the possibility of the fetus exhibits a congenital malformation secondary to medications. Lithium has been touted in the 1980s as a powerful teratogen. A review of subsequent studies conducted in the 1990s estimated that the risk of cardiac malformations should be between 0.9% to 12.0%. This article reviews the data from these studies and highlights possible biases that may cast doubt on the accepted estimates today. It was concluded that considering the serious limitations of the retrospective, case control and prospective studies about this topic, lithium should not be considered an insignificant teratogen, and hence should be given very carefully in pregnancy. When there is exposure, it is advisable to perform a fetal and neonatal echocardiography to exclude the possibility of cardiac anomalies. Antipsychotics and lamotrigine seem to be possible alternatives for the treatment of bipolar disorder during pregnancy.