Abstract

Introduction

The effects of antidepressant and antipsychotic medications in the perinatal period in both mothers and children have been a subject of interest for many decades. Risks and benefits should be considered according to the illness stage, trimester of pregnancy/ postpartum period, and neonatal outcomes.

Objectives

Our goal was to summarize the knowledge about the use of antidepressants and antipsychotics in the perinatal period. To illustrate the complexity of treatment decisions with clinical reports.

Methods

Review: A narrative review was carried out using the PubMed database including papers published in 2022. Evidence about the risks and benefits of using antidepressants and antipsychotics in the perinatal period is presented. Search terms: antidepressants OR antipsychotics AND (perinatal OR pregnancy OR postpartum).

Case reports (5 clinical scenarios): (1) pre-pregnancy counselling, (2-4) first-, second- and third-trimester of pregnancy, and (5)postpartum/breastfeeding.

Results

Review: (1)Depression/antidepressants. Treating maternal depressive symptoms is associated with a lower risk of pregnancy complications. Although placental passage of sertraline is low, drug monitoring is recommended. Antidepressant use in pregnancy is associated with preterm delivery and low weight at birth. (2)Psychosis/Antipsychotics. Antipsychotic intrauterine exposure is not significantly associated with increased risk of major congenital malformations. Minimum effective doses are recommended.

Case reports. (1)Pre-pregnancy counselling. Schizoaffective disorder receiving perphenazine, quetiapine and lithium. (2)First-trimester pregnancy. Discontinuation of treatment in major depressive disorder. (3-4)Second/third trimester. Occurrence of anxiety symptoms in posttraumatic stress disorder. (5)Postpartum/Breastfeeding. Discontinuation of antidepressants.

Conclusions

Shared decision-making models for antidepressants and antipsychotics prescription represent patient-centered approaches to be recommended in perinatal period.

Disclosure of Interest

None Declared

Details

Title
Use of psychotropic medications during pregnancy and the postpartum period: Review on Recent Works and Clinical Scenarios
Author
Román, E 1 ; Natividad, M 2 ; Cobo, J 3 ; Ayesa, R 4 ; Cachinero, H 5 ; Figueras, I 6 ; Izquierdo, E 7 ; Martínez, E 6 ; J P Paolini San Miguel 8 ; Monreal, J A 9 ; González-Rodríguez, A 10 

 Mental Health, Mutua Terrassa University Hospital. University of Barcelona (UB). CIBERSAM 
 Mental Health, Mutua Terrassa University Hospital. Fundació Docència i Recerca. University of Barcelona. CIBERSAM., Terrassa 
 Mental Health, Parc Tauli University Hospital. Autonomous University of Barcelona (UAB). I3PT. CIBERSAM, Sabadell 
 Psychiatry, Marqués Valdecilla University Hospital. IDIVAL. National University of Distance Education. CIBERSAM, Santander 
 Mental Health, Mutua Terrassa University Hospital. University of Barcelona. Fundació Docència i Recerca Mutua Terrassa 
 Mental Health, Mutua Terrassa University Hospital. Fundació Docència i Recerca Mutua Terrassa. University of Barcelona 
 Mental Health, Mutua Terrassa University Hospital. Fundació Docència i Recerca Mutua Terrassa. University of Barcelona., Terrassa 
 Mental Health, Parc Tauli University Hospital. Autonomous University Hospital. I3PT. CIBERSAM, Sabadell 
 Mental Health, Mutua Terrassa University Hospital. Fundació Docència i Recerca Mutua Terrassa. University of Barcelona. CIBERSAM. Inst . Neurociències UAB 
10  Mental Health, Mutua Terrassa University Hospital. Fundació Docència i Recerca Mutua Terrassa. University of Barcelona. CIBERSAM, Terrassa, Spain 
Pages
S1125-S1126
Publication year
2023
Publication date
Mar 2023
Publisher
Cambridge University Press
ISSN
09249338
e-ISSN
17783585
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2880583988
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association. This work is licensed under the Creative Commons Attribution License This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.