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16 - Psychopharmacology and motherhood

from Part IV - Specific treatments and service needs

Published online by Cambridge University Press:  09 August 2009

Michael Göpfert
Affiliation:
Webb House Democratic Therapeutic Community, Crewe
Jeni Webster
Affiliation:
5 Boroughs Partnership, Warrington
Mary V. Seeman
Affiliation:
University of Toronto
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Summary

One of the most difficult decisions for women suffering from a chronic or recurrent illness is whether or not to continue taking maintenance medications during pregnancy. Women know that they should not smoke, drink alcohol or take street drugs when they are pregnant. But they are unsure about prescribed medication. The dilemma is particularly difficult for women who are unclear about their need for medication. This predicament is well captured in a Canadian study of focus group discussions among women diagnosed with schizophrenia (Chisholm, 1999). In this group of women, pregnancies were reported as largely unplanned. The question they faced at the time of the pregnancy was whether to stop antipsychotic medication or, by continuing, to harm (perhaps) their developing child. These women related mixed experience with respect to the help they received from their doctors. Some found their doctors' advice helpful; others not. More than one woman in the focus groups expressed serious regret at having opted for abortion because of the impossibility of resolving this issue. The dilemma is expressed succinctly by one of the women:

One of the biggest things I had to contend with when I thought I wanted to have a baby is you can't go off your medication just like that and this medication is potentially very, extremely damaging to a fetus.

The ideal pregnancy is one that is preplanned, with the mother-to-be taking prenatal vitamins containing folic acid a full 6 weeks prior to conception.

Type
Chapter
Information
Parental Psychiatric Disorder
Distressed Parents and their Families
, pp. 241 - 248
Publisher: Cambridge University Press
Print publication year: 2004

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References

Altshuler, L. L., Cohen, L., Szuba, M. P., Burt, V. K., Gitlin, M. & Mintz, J. (1996). Pharmacologic management of psychiatric illness during pregnancy: dilemmas and guidelines. American Journal of Psychiatry, 153, 592–606Google Scholar
American Academy of Pediatrics, Committee on Drugs (1994). The transfer of drugs and other chemicals into human milk. Paediatrics, 93, 137–50
Austin, M. P., & Mitchell, P. B., (1998). Psychotropic medications in pregnant women: treatment dilemmas. Medical Journal of Australia, 169, 428–31Google Scholar
Bar-Oz, B., Nulman, I., Koren, G. & Ito, S. (2000). Anticonvulsants and breast-feeding: a critical review. Paediatric Drugs, 2, 113–26Google Scholar
Baugh, C. L. & Stowe, Z. N. (1999). Treatment issues during pregnancy and lactation. CNS Spectrums, 4, 34–9Google Scholar
Burt, V. K., Suri, R., Altschuler, L., Stowe, Z., Hendrick, V. C., & Muntean, E. (2001). The use of psychotropic medications during breast-feeding. American Journal of Psychiatry, 158, 1001–9Google Scholar
Chisholm, F. (1999). Women with Schizophrenia: An Assessment of Health Needs Across Life Stages. Report to the Manitoba Schizophrenia Society
Cohen, L. S. & Rosenbaum, J. F. (1998). Psychotropic drug use during pregnancy: weighing the risks. Journal of Clinical Psychiatry, 59 (Suppl. 2), 18–28Google Scholar
Collaborative Group on Drug Use in Pregnancy (1992). Medication during pregnancy: an intercontinental cooperative study. International Journal of Gynaecology and Obstetrics, 39, 185–96
Goldstein, D. J., Corbin, L. A. & Fung, M. C. (2000). Olanzapine-exposed pregnancies and lactation: early experience. Journal of Clinical Psychopharmacology, 20, 399–403Google Scholar
Ito, S. (2000). Drug therapy for breast-feeding women. New England Journal of Medicine, 343, 118–26Google Scholar
Klein, D. F., Skrobala, A. M. & Garfinkel, R. S. (1995). Preliminary look at the effects of pregnancy on the course of panic disorder. Anxiety, 1, 227–32Google Scholar
Koren, G., Pastuszak, A. & Ito, S. (1998). Drugs in pregnancy. New England Journal of Medicine, 338, 1128–37Google Scholar
Kumar, R. & Robson, K. M. (1984). A prospective study of emotional disorders in childbearing women. British Journal of Psychiatry, 144, 35–47Google Scholar
Liston, J. (1998). Breastfeeding and the use of recreational drugs – alcohol, caffeine, nicotine and marijuana. Breastfeeding Review, 6, 27–30Google Scholar
Llwellyn, A., Stowe, Z. N. & Strader, J. R. (1998). The use of lithium and management of women with bipolar disorder during pregnancy and lactation. Journal of Clinical Psychiatry, 59, (Suppl. 6), 57–64Google Scholar
Miller, L. J. (1994). Psychiatric medication during pregnancy: understanding and minimizing the risks. Psychiatric Annals, 24, 69–75Google Scholar
Neziroglu, F., Anemone, R. & Yaryura, T. J. A. (1992). Onset of obsessive-compulsive disorder in pregnancy. American Journal of Psychiatry, 149, 947–50Google Scholar
Rambeck, B. & Wolf, P. (1997). Lamotrigine clinical pharmacokinetics. Clinical Pharmacokinetics, 25, 433–43Google Scholar
Rambeck, B., Kurlemann, G., Stodieck, S. R., May, T. W. & Jurgens, U. (1997). Concentrations of lamotrigine in a mother on lamotrigine treatment and her newborn child. European Journal of Clinical Pharmacology, 51, 481–4Google Scholar
Roughton, E. C., Schneider, M. L., Bromley, L. J. & Coe, C. L. (1998). Maternal endocrine activation during pregnancy alters neurobehavioral state in primate infants. American Journal of Occupational Therapy, 52, 90–8Google Scholar
Samren, E. B., Duijn, C. M., Christiaens, G. C., Hofman, A. & Lindhout, D. (1999). Antiepileptic drug regimens and major congenital abnormalities in the offspring. Annals of Neurology, 46, 739–46Google Scholar

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