Mental health and pregnancy/post partum

Psychotropic drugs in pregnancy 

Psychotropic drugs with known teratogenic risk include:
  • Lithium - risk of heart defects 
  • Valproate, - neural tube defects 
  • Lamotrigine - oral cleft 
  • Paroxetine - risk of heart defects 

Lowest known risks during pregnancy: TCA 
Safest of the SSRIs: fluoxetine 

Mental health issues after childbirth 

Baby Blues
  • Affects 50-75% of post-partum women 
  • Characterised by emotional lability 
  • Occurs during the first week after birth 
  • Self-limiting 

Postnatal depression 
  • Affects 10% of new mums 
  • Tends to remit within 2 to 6 months 

Postpartum psychosis 
  • Occurs in 0.2% of childbearing women
  • Starts within the first 2 -4 weeks post delivery
  • Around 15% chance of recurrence in subsequent pregnancies

Small print gem: Taking lamotrigine while breastfeeding can cause dermatological problems in the baby, notably Stevens-Johnson syndrome 

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Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)