Review article
Antidepressant and Antipsychotic Treatment During Pregnancy
Maja Bajs Janović
Špiro Janović
Milena Skočić Hanžek
Zoran Štimac
Alma Mihaljević-Peleš
Abstract
A treatment with psychotropic medication during pregnancy is possible after serious evaluation of the risk-benefit ratio: efficacy and safety of drugs vs. potential risks to mother and child. Psychotropic drugs are prescribed before, during and after pregnancy. More than half of the women will stop treatment before or during early pregnancy which as a consequence could worsen the symptoms and negatively effect the outcome of the pregnancy. Treatment is often re-introduced in late pregnancy or after birth. The use of antidepressants and antipsychotics in pregnancy is possible when taking into consideration different effects of drugs during specific periods of fetal development. All psychotropic drugs cross the placental barrier. In the first trimester, drugs are avoided because of the risk of severe congenital malformations and miscarriage. Later there is a risk of preterm birth, changes in gestational weight, respiratory problems, neonatal syndrome and withdrawal syndrome. Specifically designed studies are needed to evaluate the impact of psychotropic drugs on the neurodevelopment in children that had been exposed to psychotropic drugs in utero. Taking drugs in pregnancy demands even more serious monitoring because of the risk of fetal malformation and perinatal and neonatal complications. Nevertheless, untreated mental illness, especially psychosis, is an independent risk for negative outcomes of pregnancy. Evaluation of the risk of untreated mental illness vs. the risk of psychotropic drug application during pregnancy is necessary.
Keywords
antidepressants; antipsychotics; pregnancy
Hrčak ID:
189149
URI
Publication date:
8.11.2017.
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