Psychopharmacologic treatment of depression during pregnancy

Increasing numbers of patients are being treated for mood disorders. Most of these patients, particularly those with the diagnosis of major depression, are women of childbearing years. Depression can also occur in the context of bipolar disorder. Concerns regarding fetal exposure to medication, either planned or unplanned, are becoming more pressing in the clinical practices of psychiatrists and primary care physicians. There are relatively few study data available to guide clinicians in the use of psychotropic medications during pregnancy, owing to obvious problems in designing studies of the effects of medications on pregnant women, fetuses, and infants. In this article clinically relevant study and practice information is provided, and suggestions regarding the approach to the treatment of mood disorders during pregnancy based on a risk assessment mode are given.