PHARMACOTHERAPY OF PSYCHIATRIC-DISORDER D URING PREGNANCY AND BREAST-FEEDING

The primary purpose of this article is to review critically the litera ture on the use of psychotropic medications in pregnancy and during br east feeding in order to suggest strategies for the clinical managemen t of these periods, Use of psychotropic medications during pregnancy m ay cause three complications: 1. teratogenicity, 2. perinatal syndrome s (neonatal toxicity), and 3. postnatal behavioural sequelae (behaviou ral toxicity). The literature features few well-controlled studies con cerning these points, so that the available information allows only fe w conclusions. Exposure to certain psychotropic drugs in utero may inc rease the risk for some specific congenital anomalies; there is mostly no strong evidence for behavioural toxicity in children exposed to ps ychotropic medications, Use of psychotropic drugs during pregnancy and breast feeding may be appropriate in many clinical situations and sho uld include thoughtful weighing of risk of pre-and postnatal exposure versus risk of relapse following drug discontinuation. The authors try to present disorder-based guidelines for psychotropic drug use during pregnancy and breast feeding and for psychiatrically ill women who wi sh to conceive.