Psychotropic medication use during pregnancy

Women can have severe and at times life-threatening psychiatric illness during pregnancy. When nonpharmacologic interventions have been attempted and are insufficient, psychotropic medication use is often necessary. The available data on prescription neuroleptic drugs suggest that with the proper selection, use, and supervision, they can be used during pregnancy. The same cannot be said for lithium carbonate or most antidepressants owing to the risks of teratogenicity and toxicity to the fetus. It is prudent to avoid all medication use, if possible, during the first trimester, but deciding how and when to institute treatment depends on an assessment of the risks associated both with the drug and with the untreated illness.