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
References
