[Psychopharmacotherapy during pregnancy : Which antipsychotics, tranquilizers and hypnotics are suitable?]

Nervenarzt. 2016 Sep;87(9):943-54. doi: 10.1007/s00115-016-0192-z.
[Article in German]

Abstract

Background: When administering psychotropic drugs during pregnancy not only the potential teratogenic effects on the child must be addressed but also the fetotoxic implications for pregnancy and/or the peripartum phase as well as possible neurocognitive developmental disorders must be considered.

Objective: Evaluation of the risks and benefits of administering psychotropic drugs during pregnancy or for women who wish to become pregnant.

Methods: The literature has been reviewed with the purpose of providing information on psychotropic drugs which can safely be administered during pregnancy. The review considers antipsychotics as well as tranquilizers and hypnotics.

Results: Data are available for a multitude of psychotropic drugs that allow a safe estimation on their suitability for use during pregnancy.

Conclusion: When treating mental illnesses during pregnancy the option of administering drugs must not principally be ruled out. What is required is an individual assessment of benefits and risks. The risk of an untreated mental illness versus the benefit of a suitable treatment, which may include the use of medication and the potential harm to the infant must be evaluated. If certain rules are observed and a suitable drug is selected the risk to the newborn child and/or mother during pregnancy can be minimized. During pregnancy, therapeutic drug monitoring is indicated and increases the safety for use of drugs and preventing harm to both mother and infant.

Keywords: Drug-induced abnormalities; Neurocognitive disorders; Review; Risk-benefit assessment; Transplacental exposure.

Publication types

  • Review

MeSH terms

  • Abnormalities, Drug-Induced / etiology
  • Abnormalities, Drug-Induced / prevention & control*
  • Antipsychotic Agents / administration & dosage*
  • Drug Administration Schedule
  • Drug Monitoring / methods
  • Drug Therapy, Combination / methods
  • Evidence-Based Medicine
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage*
  • Maternal-Fetal Exchange / drug effects
  • Mental Disorders / drug therapy*
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Prenatal Exposure Delayed Effects / chemically induced*
  • Prenatal Exposure Delayed Effects / prevention & control
  • Psychopharmacology
  • Tranquilizing Agents / administration & dosage*
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Hypnotics and Sedatives
  • Tranquilizing Agents