After all, is lithium a relevant teratogen?

Authors

  • Amaury Cantilino Diretor do Programa de Saúde Mental da Mulher da Universidade Federal de Pernambuco (UFPE). Professor Adjunto do Departamento de Neuropsiquiatria da UFPE.
  • Joel Rennó Jr Médico Psiquiatra. Diretor do Programa de Saúde Mental da Mulher (ProMulher) do Instituto de Psiquiatria do Hospital das Clínicas da Universidade de São Paulo (USP), São Paulo. Doutor em Psiquiatria pela FMUSP. Membro fundador da International Association for Women’s Mental Health. Médico do Corpo Clínico do Hospital Israelita Albert Einstein – SP. https://orcid.org/0000-0003-1954-5898
  • Hewdy Lobo Ribeiro Psiquiatra Forense, Psicogeriatra e Psicoterapeuta pela Associação Brasileira de Psiquiatria. Psiquiatra do ProMulher do Instituto de Psiquiatria da USP. https://orcid.org/0000-0001-9117-1937
  • Juliana Pires Cavalsan Psiquiatra do Programa de Saúde Mental da Mulher (ProMulher) do Instituto de Psiquiatria do Hospital das Clínicas da Universidade de São Paulo (USP), São Paulo.
  • Renan Rocha Médico Psiquiatra. Coordenador do Serviço de Saúde Mental da Mulher das Clínicas Integradas da Universidade do Extremo Sul Catarinense (UNESC)

DOI:

https://doi.org/10.25118/2763-9037.2013.v3.319

Keywords:

lithium, pregnancy, teratogenesis

Abstract

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.

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Published

2022-05-07

How to Cite

1.
Cantilino A, Rennó Jr J, Ribeiro HL, Cavalsan JP, Rocha R. After all, is lithium a relevant teratogen?. Debates Psiquiatr. [Internet]. 2022 May 7 [cited 2026 Jun. 3];3(4):24-8. Available from: https://revistardp.org.br/revista/article/view/319

Issue

Vol. 3 No. 4 (2013)

Section

Review Articles

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