TREATING RECURRENT AFFECTIVE-DISORDERS DURING AND AFTER PREGNANCY - WHAT CAN BE TAKEN SAFELY

Since pregnancy and the time thereafter is a precarious period for wom en with recurrent affective disorders and their offspring, it is impor tant to determine the risk of various treatments for such disorders. T his review assesses the risk to the fetus, the perinatal risks for mot her and infant, the risk associated with treatment during the puerperi um and breastfeeding, and the risks to the later development of the ch ild. This review considers treatment with lithium, tricyclic antidepre ssants (TCAs), selective serotonin (5-hydroxytryptamine; 5-HT) reuptak e inhibitors (SSRIs), monoamine oxidase inhibitors, other antidepressa nts, and the anticonvulsants carbamazepine and valproic acid (sodium v alproate). According to available evidence, use of lithium, TCAs and S SRIs is justified during and after pregnancy if treatment is required, no prophylactic treatment has a lower risk : benefit ratio. The revie w provides guidelines for the use of these drugs.