Pregnancy mood disorders during

Stowe ZN, Calhoun K, Ramsey C, Sadek N, Newport J. Mood disorders during pregnancy and lactation defining issues of exposure and treatment. CNS Spectrums 2001 6 150-66. 

Bipolar disorder has a lifetime prevalence of approximately 1%. During pregnancy, untreated bipolar disorder may result in hospitalization, suicidal ideation, violence, loss of employment, malnutrition, and an increased risk of postpartum psychosis. It does not appear that pregnancy provides protection for the risk of recurrence of symptoms. Women who discontinue the use of mood stabilizing drugs abruptly before conception or who have had four or more episodes of recurrence of symptoms have a substantial risk for recurrence during pregnancy. Risk for recurrence in the first 3 to 6 months postpartum has been estimated at 20% up to 80%. Postpartum psychosis may occur in 10% to 20% of women with bipolar disorder. 

Melatonin has been used to regulate the sleep-wake cycle and is used often to treat insomnia. It is not recommended during pregnancy and breast-feeding becanse of a lack of information abont its safety. Lower doses of melatonin (e.g., 0.1-1 mg at bedtime) are effective in initiating sleep higher doses may not improve the hypnotic effect. The rednction in daytime snnUght, which increases melatonin secretion, may exacerbate PMS in the winter this type of seasonal mood disorder may respond to phototherapy. Early sleep deprivation also may help to correct circadian rhythm disturbances in PMDD. ... 

---