Bipolar Depression: Pregnancy, Postpartum, and Lactation.

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Medication management of bipolar depression in pregnancy and lactation is best done by assessing each patient's and family's needs in detail. Keeping pregnant patients as psychiatrically stable as possible is the most important principle for clinicians. Unfortunately, there is no risk-free situation for patients with psychiatric illness. This is often the most difficult and hard to accept reality for these patients, families, and clinicians. Clinicians serve these patients best by being as transparent as possible about the risk/benefit analysis of each patient's situation with the realization that ultimately the decisions are made by the patient and family.





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Wald, Marla F, Andrew J Muzyk and Drue Clark (2016). Bipolar Depression: Pregnancy, Postpartum, and Lactation. The Psychiatric clinics of North America, 39(1). pp. 57–74. 10.1016/j.psc.2015.10.002 Retrieved from

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Marla F. Wald

Associate Professor of Psychiatry and Behavioral Sciences

Andrew Muzyk

Associate Professor of the Practice of Medical Education

Dr. Andrew Muzyk is an Associate Professor of the Practice of Medical Education at Duke University School of Medicine in Durham, NC and an Associate Professor in the Department of Pharmacy Practice at Campbell University College of Pharmacy and Health Sciences in Buies Creek, NC. Dr. Muzyk also holds a Clinical Associate appointment in the Duke University School of Nursing. Dr. Muzyk's responsibilities include teaching students across numerous health professions programs, rounding as a clinical pharmacist at Duke University Hospital, and conducting educational research.

Dr. Muzyk is the director of pharmacology content and the course co-adminstrator for the Foundations of Patient Care II course, a semester long course that includes pharmacology, pathology, microbiology, immunology, and clinical medicine content. He teaches pharmacology to first-year medical students at Duke University School of Medicine with a focus on CNS medications. For five years, Dr. Muzyk served as the director for the Biological Psychiatry course for psychiatry residents in the Duke Department of Psychiatry and Behavioral Sciences.

At Campbell University College of Pharmacy and Health Sciences, he teaches pharmacy students about the treatment of psychiatric and substance use disorders and men's health. Dr. Muzyk is the course co-coordinator for the pharmacoepidemiology, health informatics, and neurology-psychiatry modules. He precepts fourth-year pharmacy students completing an internal medicine or psychiatry clerkship at Duke University Hospital.

He teaches students in other health professions programs at Duke and Campbell including doctor of osteopathy, physician assistant, and nursing. His teaching in these programs focuses on the management of psychiatric and substance use disorders. Dr. Muzyk serves as a mentor for graduate students enrolled in the University of Michigan Master of Health Professions Education program.

Dr. Muzyk's clinical responsibilities include rounding at Duke University Hospital on the Medicine-Psychiatry inpatient service and providing consultation to the inpatient psychiatry unit and the opioid use disorder consult service. He is a clinical pharmacist in the Duke University Hospital Department of Pharmacy.

Dr. Muzyk has over 70 publications from research projects focused on health professions student education and hospital based medication outcomes. His work has been published in journals including Academic Medicine, Substance Abuse, Psychosomatics, Academic Psychiatry, American Journal of Pharmaceutical Education, CNS Drugs, and Pharmacotherapy. He has received approximately $170,000 in grants to support his educational research developing an interprofessional substance use disorder course for health professions students and continuing education programs for healthcare professionals. Educational research support has come from Duke Academy for Health Professions Education and Academic Development, Duke Division of Addiction Medicine, Duke Bass Connections, the Josiah Charles Trent Memorial Foundation Endowment Fund, Duke-Southern Regional Area Health Education Center, and Campbell University College of Pharmacy and Health Sciences. Dr. Muzyk has given numerous presentations throughout the United States on topics related to psychiatric and substance use disorders and health professions education. He is a speaker for the North Carolina Area Health Education Centers (AHEC).

Campbell University College of Pharmacy and Health Sciences Dean's Award for Excellence in Teaching; Association of American Medical Colleges (AAMC) Curricular Innovation Award (2020); Association for Multidisciplinary Education and Research in Substance use and Addiction (AMERSA), New Educator/Investigator award (2019); Campbell University College of Pharmacy and Health Sciences, Educator of the Year (2018); Duke University Hospital Department of Pharmacy, Educator and Researcher of the Year (2018); Duke Academy for Health Professions Education and Academic Development (Duke AHEAD), Interprofessional Excellence Award (2016); the Association of Academic Psychiatry (AAP), Psychiatric Education Award (2012); and, the North Carolina Association of Pharmacist (NCAP), Distinguished Young Pharmacist Award (2012).

Dr. Muzyk received his Doctor of Pharmacy (PharmD) degree from Mercer University College of Pharmacy in Atlanta, GA. He completed two years of post-doctorate pharmacy residency training at DCH Health System in Tuscaloosa, AL and at UNC Medical Center in Chapel Hill, NC. His second year of residency training was focused on psychiatric pharmacy practice. Dr. Muzyk obtained a Master of Health Profession Education degree from University of Michigan. In 2023, he completed a year long Climate Health Organizing Fellowship through the Center for Health Equity Education and Advocacy at Harvard Medical School and Cambridge Health Alliance.

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