Mood stabilizers and antipsychotics during breastfeeding: Focus on bipolar disorder

European Neuropsychopharmacology

Volumn 26, Issue 10, 2016, Pages 1562-1578

  Pacchiarotti, Isabella ^a   León Caballero, Jordi ^a,b   Murru, Andrea ^a   Verdolini, Norma ^a,c   Furio, Maria Antonietta ^a,d   Pancheri, Corinna ^a,e   Valentí, Marc ^a   Samalin, Ludovic ^a,f   Roigé, Eva Solé ^a   González Pinto, Ana ^g   Montes, Jose Manuel ^h   Benabarre, Antonio ^a   Crespo, Jose Manuel ⁱ   de Dios Perrino, Consuelo ^j   Goikolea, Jose Manuel ^a   Gutiérrez Rojas, Luis ^k   Carvalho, André F ^l   Vieta, Eduard ^a  

^a UNIVERSITY OF BARCELONA   (Spain)

^b CENTRO DE INVESTIGACIÓN BIOMÉDICA EN RED DE SALUD MENTAL CIBERSAM   (Spain)

^c UNIVERSITY OF PERUGIA   (Italy)

^d UNIVERSITY OF BARI   (Italy)

^e SAPIENZA UNIVERSITY OF ROME   (Italy)

^f UNIVERSITY HOSPITAL OF CLERMONT FERRAND   (France)

^g UNIVERSITY OF THE BASQUE COUNTRY UPV EHU   (Spain)

^h HOSPITAL RAMÓN Y CAJAL   (Spain)

ⁱ HOSPITAL UNIVERSITARI DE BELLVITGE   (Spain)

^j HOSPITAL UNIVERSITARIO LA PAZ   (Spain)

^k HOSPITAL UNIVERSITARIO SAN CECILIO   (Spain)

^l FEDERAL UNIVERSITY OF CEARÁ   (Brazil)

more..

Author keywords

Antipsychotics; Bipolar disorder; Breastfeeding; Lactation; Mood stabilizers

Indexed keywords

AMISULPRIDE; ARIPIPRAZOLE; CARBAMAZEPINE; CLOZAPINE; CREATININE; LAMOTRIGINE; LITHIUM; MOOD STABILIZER; NEUROLEPTIC AGENT; OLANZAPINE; OXCARBAZEPINE; QUETIAPINE; RISPERIDONE; THYROTROPIN; VALPROIC ACID; ZIPRASIDONE; TRANQUILIZER;

ABSENCE OF SIDE EFFECTS; AGRANULOCYTOSIS; ANEMIA; ANTICONVULSANT THERAPY; APNEA; BIPOLAR DISORDER; BREAST FEEDING; BREAST MILK; COGNITIVE DEFECT; CREATININE BLOOD LEVEL; CYANOSIS; DEVELOPMENTAL DISORDER; DRUG INTOXICATION; EVIDENCE BASED PRACTICE; FEMALE; HUMAN; INFANT; LACTATION; LIVER TOXICITY; META ANALYSIS; PRIORITY JOURNAL; PSYCHOMOTOR RETARDATION; RASH; REVIEW; SIDE EFFECT; SPEECH DELAY; SYSTEMATIC REVIEW; THROMBOCYTE COUNT; THROMBOCYTOPENIC PURPURA; THYROTROPIN BLOOD LEVEL; UREA NITROGEN BLOOD LEVEL; ADULT; CHEMISTRY; COMPLICATION; METABOLISM; NEWBORN; PUERPERIUM;

ADULT; ANTIMANIC AGENTS; ANTIPSYCHOTIC AGENTS; BIPOLAR DISORDER; BREAST FEEDING; FEMALE; HUMANS; INFANT, NEWBORN; MILK, HUMAN; POSTPARTUM PERIOD;

EID: 84991043168     PISSN: 0924977X     EISSN: 18737862     Source Type: Journal    
DOI: 10.1016/j.euroneuro.2016.08.008     Document Type: Review

References (94)

1. Aichhorn, W., Stuppaeck, C., Whitworth, A.B., Risperidone and breast-feeding. J. Psychopharmacol. 19 (2005), 211–213.
2. Alexander, F.W., Sodium valproate and pregnancy. Arch. Dis. Child, 54, 1979, 240.
3. Ambresin, G., Berne, P., Schulz, P., Bryois, C., Olanzapine excretion into breast milk: a case report. J. Clin. Psychopharmacol. 24 (2004), 93–95.
4. American Academy of Pediatrics, Breastfeeding and the use of human milk section on breastfeeding. Pediatrics 115 (2012), 496–506.
5. American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 361, 2007. Breastfeeding: maternal and infant aspects. Obstet Gynecol. 109, pp. 479–480, reaffirmed 2013.
6. Azorin, J.M., Angst, J., Gamma, A., Bowden, C.L., Perugi, G., Vieta, E., Young, A., Identifying features of bipolarity in patients with first-episode postpartum depression: findings from the international BRIDGE study. J. Affect. Disord. 136 (2012), 710–715.
7. Barnas, C., Bergant, A., Hummer, M., Saria, A., Fleischhacker, W.W., Clozapine concentrations in maternal and fetal plasma, amniotic fluid, and breast milk. Am. J. Psychiatry, 151, 1994, 945.
8. Bogen, D.L., Sit, D., Genovese, A., Wisner, K.L., Three cases of lithium exposure and exclusive breastfeeding. Arch. Women׳s Ment. Health 15 (2012), 69–72.
9. Chad, L., Pupco, A., Bozzo, P., Koren, G., Update on antidepressant use during breastfeeding. Can. Fam. Physician 59 (2013), 633–634.
10. Chaudron, L.H., Pies, R.W., The relationship between postpartum psychosis and bipolar disorder: a review. J Clin. Psychiatry 64 (2003), 1284–1292.
11. Chen, C.H., Lin, S.K., Carbamazepine treatment of bipolar disorder: a retrospective evaluation of naturalistic long-term outcomes. BMC Psychiatry, 23(12), 2012, 47.
12. Croke, S., Buist, A., Hackett, L.P., Ilett, K.F., Norman, T.R., Burrows, G.D., Olanzapine excretion in human breast milk: estimation of infant exposure. Int. J. Neuropsychopharmacol. 5 (2002), 243–247.
13. Davanzo, R., Dal Bo, S., Bua, J., Copertino, M., Zanelli, E., Matarazzo, L., Antiepileptic drugs and breastfeeding. Ital. J. Pediatr., 39, 2013, 50.
14. Di Florio, A., Forty, L., Gordon-Smith, K., Heron, J., Jones, L., Craddock, N., Jones, I., Perinatal episodes across the mood disorder spectrum. JAMA Psychiatry 70 (2013), 168–175.
15. Fotopoulou, C., Kretz, R., Bauer, S., Schefold, J.C., Schmitz, B., Dudenhausen, J.W., Henrich, W., Prospectively assessed changes in lamotrigine-concentration in women with epilepsy during pregnancy, lactation and the neonatal period. Epilepsy Res. 85 (2009), 60–64.
16. Frey, B., Schubiger, G., Musy, J.P., Transient cholestatic hepatitis in a neonate associated with carbamazepine exposure during pregnancy and breast-feeding. Eur. J. Pediatr. 150 (1990), 136–138.
17. Frey, B., Braegger, C.P., Ghelfi, D., Neonatal cholestatic hepatitis from carbamazepine exposure during pregnancy and breast feeding. Ann. Pharmacother. 36 (2002), 644–647.
18. Fries, H., Lithium in pregnancy. Lancet, 1, 1970, 1233.
19. Gardiner, S.J., Kristensen, J.H., Begg, E.J., Hacket, L.P., Wilson, D., Ilett, K.F., Kohan, R., Rampono, J., Transfer of olanzapine into breast milk, calculation of infant drug dose, and effect on breast-fed infants. Am. J. Psychiatry 160 (2003), 1428–1431.
20. Gentile, S., Lamotrigine in pregnancy and lactation. Arch. Women׳s Ment. Health 8 (2005), 57–58.
21. Gentile, S., Quetiapine-fluvoxamine combination during pregnancy and while breastfeeding. Arch. Women׳s Ment. Health 9 (2006), 158–159.
22. Gentile, S., Infant safety with antipsychotic therapy in breast-feeding: a systematic review. J Clin. Psychiatry 69 (2008), 666–673.
23. Gilad, O., Merlob, P., Stah, B., Klinger, G., Outcome of infants exposed to olanzapine during breastfeeding. Breastfeed. Med. 6 (2011), 55–58.
24. Goldstein, D.J., Corbin, L.A., Fung, M.C., Olanzapine-exposed pregnancies and lactation: early experience. J. Clin. Psychopharmacol. 20 (2000), 399–403.
25. Grande, I., Berk, M., Birmaher, B., Vieta, E., Bipolar disorder. Lancet, 17, 2015 pii: S0140-6736(15)00241-X.
26. Harlow, B.L., Vitonis, A.F., Sparen, P., Cnattingius, S., Joffe, H., Hultman, C.M., Incidence of hospitalization for postpartum psychotic and bipolar episodes in women with and without prior prepregnancy or prenatal psychiatric hospitalizations. Arch. Gen. Psychiatry 64 (2007), 42–48.
27. Hill, R.C., McIvor, R.J., Wojnar-Horton, R.E., Hackett, L.P., Ilett, K.F., Risperidone distribution and excretion into human milk: case report and estimated infant exposure during breast-feeding. J. Clin. Psychopharmacol. 20 (2000), 285–286.
28. Ilett, K.F., Watt, F., Hackett, L.P., Kohan, R., Teoh, S., Assessment of infant dose through milk in a lactating woman taking amisulpride and desvenlafaxine for treatment-resistant depression. Ther. Drug Monit. 32 (2010), 704–707.
29. Ilett, K.F., Hackett, L.P., Kristensen, J.H., Vaddadi, K.S., Gardiner, S.J., Begg, E.J., Transfer of risperidone and 9-hydroxyrisperidone into human milk. Ann. Pharmacother. 38 (2004), 273–276.
30. Jones, I., Chandra, P.S., Dazzan, P., Howard, L.M., Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period. Lancet 384 (2014), 1789–1799.
31. Kirchheiner, J., Berghöfer, A., Bolk-Weischedel, D., Healthy outcome under olanzapine treatment in a pregnant woman. Pharmacopsychiatry 33 (2000), 78–80.
32. Klinger, G., Stahl, B., Fusar-Pol, P., Merlob, P., Antipsychotic drugs and breastfeeding. Pediatr. Endocrinol. Rev. 10 (2013), 308–317.
33. Larsen, E.R., Damkier, P., Pedersen, L.H., Fenger-Gron, J., Mikkelsen, R.L., Nielsen, R.E., Linde, V.J., Knudsen, H.E., Skaarup, L., Videbech, P., Videbech, P., Danish Psychiatric Society, Danish Society of Obstetrics and Gynecology, Danish Paediatric Society, Danish Society of Clinical Pharmacology, Use of psychotropic drugs during pregnancy and breast-feeding. Acta Psychiatr. Scand. 445 (2015), 1–28.
34. Lee, A., Giesbrech, E., Dunn, E., Ito, S., Excretion of quetiapine in breast milk. Am. J. Psychiatry 161 (2004), 1715–1716.
35. Liporace, J., Kao, A., D׳Abreu, A., Concerns regarding lamotrigine and breast-feeding. Epilepsy Behav. 5 (2004), 102–105.
36. Lutz, U.C., Wiatr, G., Gaertner, H.J., Bartels, M., Oxcarbazepine treatment during breast-feeding: a case report. J. Clin. Psychopharmacol. 27 (2007), 730–732.
37. Lutz, U.C., Wiatr, G., Orlikowsky, T., Gaertner, H.J., Bartels, M., Olanzapine treatment during breast feeding: a case report. Ther. Drug Monit. 30 (2008), 399–401.
38. Lutz, U.C., Hiemke, C., Wiatr, G., Farger, G., Arand, J., Wildgruber, D., Aripiprazole in pregnancy and lactation: a case report. J. Clin. Psychopharmacol. 30 (2010), 204–205.
39. Maina, G., Rosso, G., Aguglia, A., Bogetto, F., Recurrence rates of bipolar disorder during the postpartum period: a study on 276 medication-free Italian women. Arch. Women׳s Ment. Health 17 (2014), 367–372.
40. Marks, J.M., Spatz, D.L., Medications and lactation: what PNPs need to know. J. Pediatr. Health Care 17 (2003), 311–317.
41. Matheson, I., Skjaeraasen, J., Milk concentrations of flupenthixol, nortriptyline and zuclopenthixol and between-breast differences in two patients. Eur J Clin Pharmacol. 35 (1988), 217–220.
42. Meador, K.J., Baker, G.A., Browning, N., Clayton-Smith, J., Combs-Cantrell, D.T., Cohen, M., Kalayjian, L.A., Kanner, A., Liporace, J.D., Pennell, P.B., Privitera, M., Loring, D.W., NEAD study group. Effects of breastfeeding in children of women taking antiepileptic drugs. Neurology 75 (2010), 1954–1960.
43. Meador, K.J., Baker, G.A., Browning, N., Cohen, M.J., Bromley, R.L., Clayton-Smith, J., Kalayjian, L.A., Kanner, A., Liporace, J.D., Pennell, P.B., Privitera, M., Loring, D.W., Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study group. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr. 168 (2014), 729–736.
44. Mendhekar, D.N., Possible delayed speech acquisition with clozapine therapy during pregnancy and lactation. J. Neuropsychiatry Clin. Neurosci. 19 (2007), 196–197.
45. Merlob, P., Mor, N., Litwin, A., Transient hepatic dysfunction in an infant of an epileptic mother treated with carbamazepine during pregnancy and breastfeeding. Ann. Pharmacother. 26 (1992), 1563–1565.
46. Misri, S., Corral, M., Wardrop, A., Kendrick, K., Quetiapine augmentation in lactation: a series of case reports. J. Clin. Psychopharmacol. 26 (2006), 508–511.
47. Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ, 21(339), 2009, b2535.
48. Moretti, M.E., Koren, G., Verjee, Z., Ito, S., Monitoring lithium in breast milk: an individualized approach for breast-feeding mothers. Ther. Drug Monit. 25 (2003), 364–366.
49. Munk-Olsen, T., Laursen, T.M., Meltzer-Brody, S., Mortensen, P.B., Jones, I., Psychiatric disorders with postpartum onset: possible early manifestations of bipolar affective disorders. Arch. Gen. Psychiatry 69 (2012), 428–434.
50. Newport, D.J., Pennell, P.B., Calamaras, M.R., Ritchie, J.C., Newman, M., Knight, B., Viguera, A.C., Liporace, J., Stowe, Z.N., Lamotrigine in breast milk and nursing infants: determination of exposure. Pediatrics 122 (2008), e223–e231.
51. Nordmo, E., Aronsen, L., Wasland, K., Småbrekke, L., Vorren, S., Severe apnea in an infant exposed to lamotrigine in breast milk. Ann. Pharmacother. 43 (2009), 1893–1897.
52. Ohman, I., Vitols, S., Tomson, T., Lamotrigine in pregnancy: pharmacokinetics during delivery, in the neonate, and during lactation. Epilepsia 41 (2000), 709–713.
53. Olesen, O.V., Bartels, U., Poulsen, J.H., Perphenazine in breast milk and serum. Am. J. Psychiatry 147 (1990), 1378–1379.
54. Pacchiarotti, I., Valentí, M., Colom, F., Rosa, A.R., Nivoli, A.M., Murru, A., Sánchez-Moreno, J., Vieta, E., Differential outcome of bipolar patients receiving antidepressant monotherapy versus combination with an antimanic drug. J. Affect. Disord. 129 (2001), 321–326.
55. Page-Sharp, M., Kristensen, J.H., Hackett, L.P., Beran, R.G., Rampono, J., Hale, T.W., Kohan, R., Ilett, K.F., Transfer of lamotrigine into breast milk. Ann. Pharmacother. 40 (2006), 1470–1471.
56. Parikh, T., Goyal, D., Scarff, J.R., Lippmann, S., Antipsychotic drugs and safety concerns for breast-feeding infants. South Med. J. 107 (2014), 686–688.
57. Philbert, A., Pedersen, B., Dam, M., Concentration of valproate during pregnancy, in the newborn and in breast milk. Acta Neurol. Scand. 72 (1985), 460–463.
58. Piontek, CM., Baab, S., Peindl, K.S., Wisner, K.L., Serum valproate levels in 6 breastfeeding mother-infant pairs. J Clin Psychiatry. 61 (2000), 170–172.
59. Pope, C.J., Sharma, V., Mazmanian, D., Bipolar disorder in the postpartum period: management strategies and future directions. Women's. Health 10 (2014), 359–371.
60. Pope, C.J., Sharma, V., Mazmanian, D., Recognition, diagnosis and treatment of postpartum bipolar depression. Expert Rev. Neurother. 14 (2014), 19–28.
61. Popovic, D., Reinares, M., Goikolea, J.M., Bonnin, C.M., Gonzalez-Pinto, A., Vieta, E., Polarity index of pharmacological agents used for maintenance treatment of bipolar disorder. Eur. Neuropsychopharmacol. 22 (2012), 339–346.
62. Rambeck, B., Kurlemann, G., Stodieck, S.R., May, T.W., Jürgens, U., Concentrations of lamotrigine in a mother on lamotrigine treatment and her newborn child. Eur. J. Clin. Pharmacol. 51 (1997), 481–484.
63. Rampono, J., Kristensen, J.H., Ilett, K.F., Hackett, L.P., Kohan, R., Quetiapine and breast feeding. Ann. Pharmacother. 41 (2007), 711–714.
64. Reinares, M., Sánchez-Moreno, J., Fountoulakis, K.N., Psychosocial interventions in bipolar disorder: what, for whom, and when. J. Affect. Disord. 156 (2014), 46–55.
65. Rowe, H., Baker, T., Hale, T.W., Maternal medication, drug use, and breastfeeding. Child Adolesc. Psychiatr. Clin. N. Am. 24 (2015), 1–20.
66. Samalin, L., Murru, A., Vieta, E., Management of inter-episodic periods in patients with bipolar disorder. Expert Rev. Neurother. 25 (2016), 1–12.
67. Schou, M., Amdisen, A., Lithium and pregnancy. 3. Lithium ingestion by children breast-fed by women on lithium treatment. BMJ, 2, 1973, 138.
68. Schou, M., Amdisen, A., Steenstrup, O.R., Lithium and pregnancy II. Hazards to women given lithium during pregnancy and delivery. BMJ 2 (1973), 137–138.
69. Shimoyama, R., Ohkubo, T., Sugawara, K., Monitoring of carbamazepine and carbamazepine 10,11-epoxide in breast milk and plasma by high-performance liquid chromatography. Ann. Clin. Biochem. 37 (2000), 210–215.
70. Stahl, M.M., Neiderud, J., Vinge, E., Thrombocytopenic purpura and anemia in a breast-fed infant whose mother was treated with valproic acid. J. Pediatr. 130 (1997), 1001–1003.
71. Stowe, Z.N., The use of mood stabilizers during breastfeeding. J. Clin. Psychiatry 68:Suppl. 9 (2007), 22–28.
72. Sykes, P.A., Quarrie, J., Alexander, F.W., Lithium carbonate and breast-feeding. BMJ, 2, 1976, 1299.
73. Tanaka, T., Moretti, M.E., Verjee, Z.H., Shupak, M., Ivanyi, K.E., Ito, S., A pitfall of measuring lithium levels in neonates. Ther. Drug Monit. 30 (2008), 752–754.
74. Teoh, S., Ilett, K.F., Hackett, L.P., Kohan, R., Estimation of rac-amisulpride transfer into milk and of infant dose via milk during its use in a lactating woman with bipolar disorder and schizophrenia. Breastfeed. Med. 6 (2011), 85–88.
75. Tomson, T., Ohman, I., Vitols, S., Lamotrigine in pregnancy and lactation: a case report. Epilepsia 38 (1997), 1039–1041.
76. Tunnessen, W.W., Hertz, C.G., Toxic effects of lithium in newborn infants: a commentary. J. Pediatr. 81 (1972), 804–807.
77. Veiby, G., Engelsen, B.A., Gilhus, N.E., Early child development and exposure to antiepileptic drugs prenatally and through breastfeeding: a prospective cohort study on children of women with epilepsy. JAMA Neurol. 70 (2013), 1367–1374.
78. Vieta, E., Panicali, F., Goetz, I., Reed, C., Comes, M., Tohen, M., EMBLEM Advisory Board. Olanzapine monotherapy and olanzapine combination therapy in the treatment of mania: 12-week results from the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) observational study. J. Affect. Disord. 106 (2008), 63–72.
79. Vieta, E., Locklear, J., Günther, O., Ekman, M., Miltenburger, C., Chatterton, M.L., Aström, M., Paulsson, B., Treatment options for bipolar depression: a systematic review of randomized, controlled trials. J. Clin. Psychopharmacol. 30 (2010), 579–590.
80. Vieta, E., Gunther, O., Locklear, J., Ekman, M., Miltenburger, C., Chatterton, M.L., Åström, M., Paulsson, B., Effectiveness of psychotropic medications in the maintenance phase of bipolar disorder: a meta-analysis of randomized controlled trials. J. Clin. Psychopharmacol. 14 (2011), 1029–1049.
81. Vieta, E., Cruz, N., García-Campayo, J., de Arce, R., Manuel Crespo, J., Vallès, V., Pérez-Blanco, J., Roca, E., Manuel Olivares, J., Moríñigo, A., Fernández-Villamor, R., Comes, M.A., Double-blind, randomized, placebo-controlled prophylaxis trial of oxcarbazepine as adjunctive treatment to lithium in the long-term treatment of bipolar I and II disorder. Int. J. Neuropsychopharmacol. 11 (2008), 445–452.
82. Viguera, A.C., Nonacs, R., Cohen, L.S., Tondo, L., Murray, A., Baldessarini, R.,J., Risk of recurrence of bipolar disorder in pregnant and nonpregnant women after discontinuing lithium maintenance. Am. J. Psychiatry 157 (2000), 179–184.
83. Viguera, A.C., Tondo, L., Koukopoulos, A.E., Reginaldi, D., Lepri, B., Baldessarini, R.J., Episodes of mood disorders in 2,252 pregnancies and postpartum periods. Am. J. Psychiatry 168 (2011), 1179–1185.
84. Viguera, A.C., Whitfield, T., Baldessarini, R.J., Newport, D.J., Stowe, Z., Reminick, A., Zurick, A., Cohen, L.S., Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood stabilizer discontinuation. Am. J. Psychiatry 164 (2007), 1817–1824.
85. Von Unruh, G.E., Froescher, W., Hoffmann, F., Niesen, M., Valproic acid in breast milk: how much is really there?. Ther. Drug Monit. 6 (1984), 272–276.
86. Wakil, L., Epperson, C.N., Gonzalez, J., O׳Reardon, J.P., Kim, D.R., Neonatal outcomes with the use of lamotrigine for bipolar disorder in pregnancy and breastfeeding: a case series and review of the literature. Psychopharmacol. Bull. 42 (2009), 91–98.
87. Watanabe, N., Kasahara, M., Sugibayashi, R., Nakamura, T., Nakajima, K., Watanabe, O., Murashima, A., Perinatal use of aripiprazole: a case report. J. Clin. Psychopharmacol. 31 (2011), 377–379.
88. Weinstein, M.R., Goldfield, M., Lithium carbonate treatment during pregnancy; report of a case. Dis. Nerv. Syst. 30 (1969), 828–832.
89. Werremeyer, A., 2009. Ziprasidone and citalopram use in pregnancy and lactation in a woman with psychotic depression. Am. J. Psychiatry. 166, 1298.
90. Whalley, L.J., Blain, P.G., Prim, J.K., Haloperidol secreted in breast milk. Br. Med. J. 282 (1981), 1746–1747.
91. Whitworth, A., Stuppaeck, C., Yazdi, K., Kralovec, K., Geretsegger, C., Zernig, G., Aichhorn, W., Olanzapine and breast-feeding: changes of plasma concentrations of olanzapine in a breast-fed infant over a period of 5 months. J. Psychopharmacol. 24 (2010), 121–123.
92. Wisner, K.L., Perel, J.M., Serum levels of valproate and carbamazepine in breastfeeding mother-infant pairs. J. Clin. Psychopharmacol. 18 (1998), 167–169.
93. Yildiz, A., Vieta, E., Leucht, S., Baldessarini, R.J., Efficacy of antimanic treatments: meta-analysis of randomized, controlled trials. Neuropsychopharmacology 36 (2011), 375–389.
94. Yoshida, K., Smith, B., Craggs, M., Kumar, R., Neuroleptic drugs in breast-milk: a study of pharmacokinetics and of possible adverse effects in breast-fed infants. Psychol. Med. 28 (1998), 81–91.