E. Davids et al., PHARMACOTHERAPY OF PSYCHIATRIC-DISORDER D URING PREGNANCY AND BREAST-FEEDING, Fortschritte der Neurologie, Psychiatrie, 66(5), 1998, pp. 207-224
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.