There are numerous aspects of perinatal BD pharmacology that require further study. To date, no RCTs have been completed in this population. However, these RCTs would be challenging to feasibly do given ethical concerns. Studies in the acute treatment of BD both during pregnancy and the postpartum are needed. Currently, evidence on the effectiveness of various mood-stabilizing medications must be extrapolated from studies done in non-perinatal populations, many of which specically excluded pregnant and postpartum women. Existing perinatal literature is heavily focused on BD I as there has only been a single study with an exclusive focus on the management of perinatal BD II (Sharma etal. 2013). It is not yet known if there are signicant pathophysiological differences between BD in the perinatal period versus BD in other periods of a woman’s life. Should signicant differences exist, this could suggest that a different approach to treatment would be indicated. Another emerging issue is a lack of pregnancy safety data for many of the newer antipsychotic medications being used to treat BD.This lack of data makes it very difcult for clinicians to discuss the risks of treatment with pregnant women which is vital in allowing them to make informed treatment decisions. Further col­lection of safety data on these medications will be imperative to allow women to make informed decisions about their treatment during the antenatal period.