Risks/safety of psychotropic medication use during pregnancy--Motherisk Update 2008

Psychiatric disorders are relatively common among women of childbearing age, who may be prescribed psychotropic drugs. There remains a high level of anxiety regarding their safety among patients and healthcare providers alike, most likely because of the conflicting studies that have been published in the literature and warnings from government organizations. Consequently, treating a psychiatric disorder during pregnancy with pharmacotherapy, is a complex decision making process, which has to be made between the pregnant woman and her healthcare provider. The objective of this brief review is to discuss the current models for studying the use of drugs in pregnancy and to provide current information on the safety/risk of psychotropic drugs used in pregnancy. The body of evidence in the literature to date suggests that psychotropic drugs as a group are relatively safe to take during pregnancy and women and their health care providers should not be unduly concerned if a woman requires treatment. Optimal control of the psychiatric disorder should be maintained during pregnancy, the post partum period and thereafter.All pregnancies where a mother has a serious psychiatric disorder should be considered high risk and the mother and fetus must be carefully monitored.