Pregnancy & Medications - MGH Center for Women's Mental Health

Cognitive Development in Children Exposed to Levetiracetam (Keppra)

An increasing number of reproductive age women now take newer anticonvulsants for the treatment of mood and anxiety disorders; however, information regarding the reproductive safety of these medications is limited. A recent study has evaluated the cognitive and language development of children born to women with epilepsy exposed in utero to levetiracetam (LEV, Keppra) or sodium valproate (VPA, Depakote), as compared to control children born to women without epilepsy not taking medication during pregnancy.

By MGH Center for Women's Mental Health|2014-01-24T17:57:32-04:00January 14th, 2014|Anti-Epileptic Drugs, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

Do SSRIs Increase the Risk of Postpartum Hemorrhage? Maybe, But Not By Much

Selective serotonin reuptake inhibitor (SSRI) antidepressants may affect platelet aggregation and thus may increase the risk of bleeding. Several studies have sought to determine if exposure to SSRI antidepressants in late pregnancy is associated with an increased risk of postpartum hemorrhage.

By MGH Center for Women's Mental Health|2014-01-24T17:58:42-04:00December 24th, 2013|Antidepressants, Outcomes, Pregnancy & Medications, Pregnancy Outcomes|Comments Off

Levetiracetam (Keppra) and Pregnancy

While it is well-established that several of the older anticonvulsants, including valproate (Depakote), carry a significant teratogenic risk, less is known about the reproductive safety of the newer antiepileptic drugs (AEDs). A new report from the U.K. and Ireland Epilepsy and Pregnancy Registers suggests that the risk of malformations associated with levetiracetam (LVT, Keppra) use during pregnancy is low.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:11-04:00November 4th, 2013|Anti-Epileptic Drugs, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Prenatal Exposure to Antiepileptic Drugs Associated with Worse Developmental Outcomes

We have previously written about studies which indicate that prenatal exposure to antiepileptic drugs (AEDs), particularly valproic acid, may adversely affect the developing fetus. Numerous studies have documented long-term effects of antiepileptic exposure on cognitive functioning: prenatal exposure to AEDs has been associated with lower IQs, as well as lower scores on tests of executive functioning, memory, verbal and nonverbal abilities, in children at 6 yeas of age (Meador KJ et al, 2012). These deficits were the most prominent in children exposed to valproic acid.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:12-04:00September 27th, 2013|Anti-Epileptic Drugs, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

More Data on the Use of Atypical Antipsychotics During Pregnancy

Despite the use of the newer “atypical” antipsychotic agents to treat a spectrum of psychiatric disorders, including schizophrenia, bipolar disorder, major depression, PTSD and other anxiety disorders, three is relatively little data on the reproductive safety of these newer atypical agents.

By Ruta Nonacs, MD PhD|2024-04-14T16:17:26-04:00September 11th, 2013|Antipsychotic Medications, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

New FDA Pregnancy Category Labeling: Still Waiting…

This is a very nice article published by the College of Psychiatric and Neurologic Pharmacists discussing the limitations of the current FDA pregnancy category labeling system.

By MGH Center for Women's Mental Health|2015-08-06T09:08:09-04:00August 6th, 2013|Pregnancy & Medications, Psychiatric Disorders During Pregnancy|Comments Off

SSRIs and Benzodiazepines: Reproductive Safety of Combined Treatment

Serotonin reuptake inhibitors (SSRIs) are frequently combined with benzodiazepines for the management of anxiety disorders or major depression with comorbid anxiety. While we have data regarding the reproductive safety of both the SSRIs and benzodiazepines, we have much less information on outcomes in women taking SSRIs and benzodiazepines together. A previous study (Oberlander 2008) found that neither the use of an SSRI alone nor the use of a benzodiazepine alone increased the risk for congenital malformation; however, in this study, the combined use of the two drugs increased the risk of cardiovascular defect. A recent study reassesses the risk of major malformation in women taking SSRIs combined with benzodiazepines.

By MGH Center for Women's Mental Health|2015-08-06T09:31:18-04:00June 12th, 2013|Pregnancy & Medications|Comments Off

Prevalence and Trends in the Use of Antipsychotic Medications during Pregnancy

Since their introduction in the 1990s, atypical (second-generation) antipsychotics have replaced typical (first generation) antipsychotics as the first-line treatment for schizophrenia and related psychotic disorders. These drugs are widely used by reproductive age women across many other disease states including bipolar disorder, major depression and anxiety disorders as either primary or adjunctive treatments.

By Ruta Nonacs, MD PhD|2024-04-14T16:17:44-04:00June 10th, 2013|Antipsychotic Medications, Pregnancy & Medications|Comments Off

Prenatal Exposure to Antidepressants and Risk of Autism

It is estimated that autism spectrum disorders (ASD) affect about 1% to 2% of children. Research carried out in twins and families indicate that ASD is highly heritable; however, it is generally believed that while genetic factors play an important role, there is an interplay between genetic and environmental factors in the etiology of this disorder. Various environmental exposures have been implicated, including vaccinations, mercury, air pollution, insecticides, and infection.

By MGH Center for Women's Mental Health|2015-08-06T09:41:13-04:00May 29th, 2013|Antidepressants, Autism Spectrum Disorder, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

Valproic Acid and Pregnancy: FDA Issues Warning

There have been multiple recent reports indicating that the use of valproate during pregnancy may be associated with lower IQ, cognitive problems, and developmental delays in exposed children. This has prompted the FDA to issue a warning regarding the use of valproate-containing drugs, including Depakote and Depakene, during pregnancy:

By MGH Center for Women's Mental Health|2015-08-06T09:43:35-04:00May 21st, 2013|Anti-Epileptic Drugs, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off