Mood disturbance and pregnancy: pros and cons of pharmacologic treatment

Abstract

The management of psychiatric disturbances during pregnancy, particularly depression and bipolar disorders, is complex. This article reviews the existing data regarding the impact of an untreated psychiatric illness on the infant's development. In addition, the potential risks to the fetus due to prenatal exposure to different psychotropic agents, including antidepressants, mood stabilizers, antipsychotics, and benzodiazepines, are summarized. Moreover, this article emphasizes that no decision is risk-free, and the ultimate goal is to reduce the exposure to both the illness and the potential teratogenic effects of the treatment. Therefore, clinicians should seek a treatment strategy, which poses the least risk for both mother and infant.

Depression During Pregnancy: Review of Epidemiological and Clinical Aspects in Developed and Developing Countries

“…Treatment of gestational depression is a complex task. Cases need to be treated on an individual basis and taking in account the patients' autonomy and their social context, emphasizing early intervention (Coverdale et al, 1997;Marcus et al, 2001;Gold, 1999;Soares et al, 2001). The use of psychoactive medication during pregnancy and lactation must take needs to be carefully evaluated since treating may affect the fetus' health (Bonari et al, 2004;Cohen et al, 2004;Jablensky, 2005;O'Brien et al, 2007;Paton, 2008).…”