MS2 09 Pregnancy and Psychotropics (from Bipolar &
Depression Treatment lectures)|Optimize your exam
success with MS2 09 lecture notes on Pregnancy and
Psychotropics from the Bipolar & Depression Treatment
series. Gain crucial insights for a comprehensive
Antipsychotics - First Gen (Typical) in Pregnancy
Do they increase risk of Teratogenicity wrt Major physical malformations
Probably no (Most studies: No)
Antipsychotics - Second Gen (Atypical) in Pregnancy
Do they increase risk of Teratogenicity wrt Major physical malformations?
Likely some risk:
some evidence first trimester (T1) exposure does increase major malformns (5.2% abs
risk with T1 exposure vs 2.5% no T1 exposure)
Benzodiazepines: Do they increase risk of Teratogenicity wrt Major physical
malformations
Probably not, but if so, probably small abs risk
Lithium Teratogenicity ?increased risk of Teratogenicity wrt Major physical
malformations
A little incr abs risk of congenital abnormalities (7 per 1000) is considered small
evidence that lithium causes Ebsteins anomaly is uncertain
Valproic acid: ? increased risk of Teratogenicity wrt Major physical malformations
Yes, cardiovascular defects, neural tube defects and intellectual disability
1. Symptoms of Poor Neonatal Adaptation 2. Caused by what prenatal
medication?
1. Symptoms: usu mild irritability, jitteriness; rarely severe 2. any SSRI in THIRD
Trimester
Persistent pulmonary hypertension by SSRI exposure to newborn 1. Define 2.
When is exposure?
Definition: Abnormal development of pulmonary vasculature so that pulmonary vascular
resistance remains elevated after birth, resulting in right-to-left shunting of blood leads
to hypoxemia Caused by exposure to SSRI in third trimester
Persistent Pulmonary Hypertension in newborn - what is cause?
Cause: mother takes SSRI in third trimester
Risk to the newborn if mother takes SSRI during the third trimester?
1. persistent pulmonary hypertension 2. neonatal adaptation syndrome
Which antiepileptic/mood stabilizers is avoided when possible in women of
reproductive age because of the high rate of intellectual disability in newborns if
taken by the mother during pregnancy?
valproic acid
A new mother starts antidepressants. She is breast feeding. Should she stop?
No. Benefits outweigh risks;
Which SSRIs appear to have least risk in patient who is breast feeding? Why?
sertraline or paroxetine. They have low/undetectable levels in breast milk;
Depression Treatment lectures)|Optimize your exam
success with MS2 09 lecture notes on Pregnancy and
Psychotropics from the Bipolar & Depression Treatment
series. Gain crucial insights for a comprehensive
Antipsychotics - First Gen (Typical) in Pregnancy
Do they increase risk of Teratogenicity wrt Major physical malformations
Probably no (Most studies: No)
Antipsychotics - Second Gen (Atypical) in Pregnancy
Do they increase risk of Teratogenicity wrt Major physical malformations?
Likely some risk:
some evidence first trimester (T1) exposure does increase major malformns (5.2% abs
risk with T1 exposure vs 2.5% no T1 exposure)
Benzodiazepines: Do they increase risk of Teratogenicity wrt Major physical
malformations
Probably not, but if so, probably small abs risk
Lithium Teratogenicity ?increased risk of Teratogenicity wrt Major physical
malformations
A little incr abs risk of congenital abnormalities (7 per 1000) is considered small
evidence that lithium causes Ebsteins anomaly is uncertain
Valproic acid: ? increased risk of Teratogenicity wrt Major physical malformations
Yes, cardiovascular defects, neural tube defects and intellectual disability
1. Symptoms of Poor Neonatal Adaptation 2. Caused by what prenatal
medication?
1. Symptoms: usu mild irritability, jitteriness; rarely severe 2. any SSRI in THIRD
Trimester
Persistent pulmonary hypertension by SSRI exposure to newborn 1. Define 2.
When is exposure?
Definition: Abnormal development of pulmonary vasculature so that pulmonary vascular
resistance remains elevated after birth, resulting in right-to-left shunting of blood leads
to hypoxemia Caused by exposure to SSRI in third trimester
Persistent Pulmonary Hypertension in newborn - what is cause?
Cause: mother takes SSRI in third trimester
Risk to the newborn if mother takes SSRI during the third trimester?
1. persistent pulmonary hypertension 2. neonatal adaptation syndrome
Which antiepileptic/mood stabilizers is avoided when possible in women of
reproductive age because of the high rate of intellectual disability in newborns if
taken by the mother during pregnancy?
valproic acid
A new mother starts antidepressants. She is breast feeding. Should she stop?
No. Benefits outweigh risks;
Which SSRIs appear to have least risk in patient who is breast feeding? Why?
sertraline or paroxetine. They have low/undetectable levels in breast milk;
