01.01.2016 | Complex Medical-Psychiatric Issues (MB Riba, Section Editor)
Managing Your Own Mood Lability: Use of Mood Stabilizers and Antipsychotics in Pregnancy
Erschienen in: Current Psychiatry Reports | Ausgabe 1/2016
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Preconception planning is very helpful when it can be done; consider discussion and documentation of risks at time of administration of psychotropic medications for any reproductive-aged women, regardless of plans for conception.
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Continued psychiatric stability through the perinatal period is imperative; the risks of an untreated psychiatric disorder are just as important, if not more so important, than the risks of psychotropic medication exposure.
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Exposure to one psychotropic medication is safer than exposure to multiple medications.
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Utilize lowest effective dose of medication; most risks are not dose dependent, therefore would typically prefer higher dose of medication, rather than emergence of psychiatric symptoms, in order to avoid exposure of the fetus to both psychotropic medications and psychiatric symptoms.
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General recommendations are to avoid valproate and carbamazepine in reproductive-aged women.
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With close monitoring, lithium can be safely utilized in pregnancy.
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Preliminary data regarding use of atypical antipsychotics is reassuring in regards to major malformations; however, larger numbers of participants are needed to provide more complete reproductive safety data with this class.
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Clearly document risks of an untreated psychiatric illness as well as risks of psychotropic medication management to the mother and developing fetus/neonate.