Mariella Suleiman, MD

All Publications

• Informed consent and contraception when prescribing valproate to individuals of childbearing potential: a quality improvement project ARCHIVES OF WOMENS MENTAL HEALTH Suleiman, M., Jarahzadeh, N., Belikova, A., Jani, H., Bodic, M., Ginsburg, P., Jacob, T., Carlini, S. V. 2026; 29 (1): 18

  Abstract

  Valproate is an efficacious treatment for several neurologic and psychiatric disorders, but it carries a grave risk of teratogenicity. Despite warnings from regulatory bodies, prescribing guidelines from professional associations, and expert opinion against the practice, the medication continues to be commonly prescribed to persons with childbearing potential for psychiatric indications.A quality improvement focused educational intervention on the conduct and documentation of informed consent and contraceptive counseling when prescribing the teratogen valproate to individuals aged 12-55 who may become pregnant was implemented in the Psychiatry Department of an urban community hospital. Documentation from 3 months before and after the intervention was qualitatively assessed for notation of informed consent, including the patient's expressed understanding of risks as well as specific counseling on teratogenicity and the need for contraception, in acute care and outpatient charts that had a prescription from a psychiatric provider for valproate in that time frame.While statistically significant improvement was found in the documentation of general informed consent and patients' responses to counseling in outpatient charts, there was no improvement in acute care charts and no significant increase in valproate-specific counseling in charts from either care setting.The minimal impact of an educational initiative on documentation of informed consent in the present study suggests that education alone may not be sufficient to address the crucial safety concern of valproate prescribing practices in psychiatric patients who may become pregnant.

  View details for DOI 10.1007/s00737-025-01639-1

  View details for Web of Science ID 001661807700001

  View details for PubMedID 41537907

  View details for PubMedCentralID 5269518

• Correction: Management of Bipolar Disorder in Pregnancy and Postpartum: A Clinicians' Guide. CNS drugs Bergink, V., Suleiman, M., Hennen, M. A., Robakis, T. 2025

  View details for DOI 10.1007/s40263-025-01239-8

  View details for PubMedID 41099781

• Beyond the Boxed Warning: A Call for Regulation of Psychiatry's Most Teratogenic Drug. The Journal of clinical psychiatry Suleiman, M., Silver, D. F., Forray, A., Goodsmith, N. 2025; 86 (4)

  View details for DOI 10.4088/JCP.25com16026

  View details for PubMedID 41060070

• Management of Agitation in Pregnancy: Collaborative Education to Improve Safety and Care. Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry Suleiman, M., Gandra, I., DeCaire, C., Tiwari, S., Carlini, S. V. 2025

  View details for DOI 10.1007/s40596-025-02222-7

  View details for PubMedID 40921916

  View details for PubMedCentralID 10920402

• It Takes a Village: A Multidisciplinary Approach to Catatonia in Pregnancy. The primary care companion for CNS disorders Mohammad, A. A., Suleiman, M., Klaine, P. P. 2025; 27 (4)

  View details for DOI 10.4088/PCC.25cr03966

  View details for PubMedID 40875884

• Management of Bipolar Disorder in Pregnancy and Postpartum: A Clinicians' Guide. CNS drugs Bergink, V., Suleiman, M., Hennen, M., Robakis, T. 2025

  Abstract

  Medication management in women with bipolar disorder (BD) in the perinatal period is challenging, given that many patients taper or stop medication during pregnancy, and the postpartum period is an extremely high-risk period for relapse. The objective of this narrative review was to investigate the perinatal efficacy as well as potential adverse effects on the child of common treatments for bipolar disorder. These treatments include lithium, lamotrigine, other antiepileptics, quetiapine, olanzapine, aripiprazole, other antipsychotics, antidepressants, benzodiazepines, Z-drugs, and other sleep medication. Despite the worldwide decline in lithium use, it remains the gold standard for acute and maintenance treatment of BD, and we continue to advise its use in women of reproductive age. In contrast, medications with a high risk for teratogenicity such as valproate and carbamazepine should be avoided in women of childbearing potential. Women with bipolar disorder are at very high risk of relapse after delivery, but this risk is more than twofold lower with adequate pharmacological prophylaxis. We advise to make a written perinatal bipolar relapse prevention plan in collaboration with the patient, family, and healthcare professionals, which includes a description of: (1) maintenance treatment during pregnancy, (2) preferred mode of delivery, (3) medication immediately after delivery and the first months postpartum for relapse prevention, (4) preferred plan for feeding (breast-feeding versus bottle-feeding), (5) strategies to assist women in ensuring adequate sleep and stable circadian rhythm in the first weeks after delivery, and (6) how to recognize the first symptoms of relapse and which intervention strategies to take.

  View details for DOI 10.1007/s40263-025-01202-7

  View details for PubMedID 40593436

• Endorsement of and Support for Required Reproductive Psychiatry Training within Accredited Psychiatry Residencies: Influencing the Accreditation Council for Graduate Medical Education (ACGME) Rodriguez-Cabezas , L., Silver , D., Suleiman , M., Koire , A., Mergler , R., Fonseca , F. American Psychiatric Association Action Paper . 2025
• Position Statement on Improving Reproductive Psychiatry Training Across Specialties Silver , D., Mergler , R., Suleiman , M. American Psychiatric Association Position Statement. 2025
• Prevalence of Community Perinatal Psychiatrists in the US. JAMA network open Koire, A., Suleiman, M., Teslyar, P., Liu, C. H. 2024; 7 (8): e2426465

  View details for DOI 10.1001/jamanetworkopen.2024.26465

  View details for PubMedID 39110463

  View details for PubMedCentralID PMC11307129

• A Rose by Any Other Name: Gender-Affi rming Care and Severe Mental Illness PSYCHIATRIC ANNALS Hayes, S., Suleiman, M., Slobod, E., Eschenbach, S. K. 2023; 53 (5): 221-223

  View details for DOI 10.3928/00485713-20230404-01

  View details for Web of Science ID 000994144200007

• From Mushrooms to Myolysis: A Case of Rhabdo in Psilocybin-Induced Mood and Psychotic Disorder. The Journal of nervous and mental disease Suleiman, M., Basu, A., Belal, S., Jacob, T. 2022; 210 (8): 638-639

  Abstract

  The involvement of certain recreational drugs, namely, hallucinogens, in the development of hyperactive syndromes is well known, but not well studied. In this report, we expand on this relationship by documenting the development of substance-induced psychosis in a young patient who used a large amount of psilocybin and developed symptoms of a first psychotic and manic episode, complicated by violent behavior and rhabdomyolysis. We further evaluate the association between psilocybin use and rhabdomyolysis and explore this understudied phenomenon and differentiate it from the diagnoses of other hyperactive syndromes seen in psychiatry. This case exemplifies the need for increased vigilance in psilocybin microdosing therapy and for physicians to be mindful of how each patient responds to its use to prevent life-threatening hyperactive syndromes in its wake.

  View details for DOI 10.1097/NMD.0000000000001489

  View details for PubMedID 35900779