Considerations in the management of bipolar disorder in women
Article first published online: 28 JUL 2005
Australian and New Zealand Journal of Psychiatry
Volume 39, Issue 8, pages 662–673, August 2005
How to Cite
Barnes, C. and Mitchell, P. (2005), Considerations in the management of bipolar disorder in women. Australian and New Zealand Journal of Psychiatry, 39: 662–673. doi: 10.1111/j.1440-1614.2005.01650.x
- Issue published online: 28 JUL 2005
- Article first published online: 28 JUL 2005
- Received 16 July 2004; revised 3 February 2005; accepted 12 February 2005.
- bipolar disorder;
Objective: Recent research has emphasized important gender differences in the epidemiology, course, comorbidity and treatment of bipolar disorder. This article aims to provide an overview of these important findings in order to assist the clinician in treating women with bipolar disorder. Complex issues regarding the treatment of bipolar disorder during pregnancy and the post-partum period are discussed.
Method: A literature review was undertaken using Medline (1966–current), PsychInfo and PubMed databases. Search terms used were gender, sex, women, bipolar disorder, suicide, epidemiology, rapid cycling, mixed episode, treatment, mood stabilizers, antidepressants, antipsychotics, pregnancy, post-partum, menopause, lactation and breast-feeding.
Results: The lifetime prevalence of bipolar I disorder is equal in men and women; however, bipolar II appears to be more common in women. Gender differences have been reported in the phenomenology, course and outcome of this condition. Some comorbid disorders, such as thyroid disease and anxiety disorders have more relevance to women. Increasingly, sex differences in the pharmacokinetics and pharmacodynamics of medications used in bipolar disorder are being reported.
Conclusions: There is increasing evidence for gender differences in a number of clinical features of bipolar disorder that have relevance to management. Although more studies are needed, it is important for clinicians to be aware of these issues to optimize treatment of women with this condition.