COURSE OF MOOD AND ANXIETY DISORDERS DURING PREGNANCY AND THE POSTPARTUM PERIOD

Because the onset of mood and anxiety disorders often occurs during th e childbearing years, many women may be taking psychotropic medication s for these disorders when they conceive. These medications easily dif fuse across the placenta, and their impact on the fetus is of concern. But discontinuation may lead to relapse, in which case psychiatric sy mptoms may affect the fetus. Thoughtful treatment planning presents a dilemma to the clinician. Limited data suggest heightened vulnerabilit y to relapse of mood and anxiety disorders in women during the postpar tum period. Pregnancy appears to exacerbate symptoms of obsessive-comp ulsive disorder, while panic disorder patients may remain well after d iscontinuing medication. Future studies should address the prevalence and relapse rates of mood and anxiety disorders, particularly after me dication discontinuation, among pregnant women.