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

Discontinuation of Antidepressants: Slower is Better

About half of all pregnancies are unplanned. In this situation, many women who conceive while on psychotropic medications decide to abruptly stop their medications when they discover they are pregnant. While this may seem like the safest option, in terms of protecting the developing fetus, we have data demonstrating high rates of relapse in women who discontinue antidepressant medications or mood stabilizers proximate to conception. We now have data (from several studies in non-pregnant populations) to indicate that the rate of medication discontinuation (abrupt vs. gradual) may also affect risk of relapse.

By MGH Center for Women's Mental Health|2015-08-13T11:01:51-04:00September 13th, 2010|Anxiety Disorders, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Should SSRIs Be Tapered Prior To Delivery?

Increased muscle tone, jitteriness, sleep disturbance, irritability, feeding problems, mild respiratory distress and myoclonus have been reported as symptoms of a potential neonatal distress syndrome related to exposure to SSRIs in late pregnancy. The average duration of symptoms reported is 48 hours. It is estimated that between 25-30% of SSRI-exposed infants are at risk for this syndrome. No treatment intervention is required. Reassuringly, follow-up studies have shown that at 2, 4, 6, and 8 months SSRI-exposed infants are indistinguishable from control infants without known exposure.

By MGH Center for Women's Mental Health|2015-08-12T17:01:53-04:00September 8th, 2010|Anxiety Disorders, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

The Importance of Proper Dosing of Antidepressants during Pregnancy

Pregnancy and the postpartum period is a time of increased risk for depression. Therefore, women who are treated with antidepressant medications must consider whether or not to stay on medication during pregnancy. Despite reassuring data regarding the reproductive safety of various antidepressants, a woman may prefer not to continue medication during pregnancy due to concerns about long term effects of medication on the baby. However, by discontinuing antidepressant medication, a woman increases her risk of depression during pregnancy. This is a highly personal decision for women as the potential risks of continuing medication must be weighed against the possibility of relapse and the potential effects of untreated depression on the pregnancy and baby.

By MGH Center for Women's Mental Health|2015-08-12T16:58:36-04:00August 30th, 2010|Anxiety Disorders, Depressive Disorders, Medication, Pregnancy & Medications, Psychiatric Disorders During Pregnancy, Treatment|Comments Off

Antidepressants and Risk of Spontaneous Abortion

Although the last several decades of research have yielded important findings regarding the safety of antidepressants during pregnancy, some areas are still understudied. For example, there are no conclusive results concerning the risk of spontaneous abortions following antidepressant exposure during the first trimester. Several recent meta-analyses, including one from the Motherisk program (Hemels, 2005), have observed an increased risk of spontaneous abortion among women taking antidepressants.

By MGH Center for Women's Mental Health|2015-08-12T16:45:03-04:00June 21st, 2010|Antidepressants, Outcomes, Pregnancy & Medications, Pregnancy Outcomes|Comments Off

Valproic Acid and the Risk of Major Malformations

Previous studies have indicated that infants exposed to valproic acid in pregnancy are at increased risk for a range of malformations, including neural tube defects. While these studies have shown an association between valproic acid and various malformations, they have been limited in their ability to quantify the risk of certain, less common malformations. To do this, large population-based case–control studies are more appropriate.

By MGH Center for Women's Mental Health|2015-08-12T16:43:09-04:00June 14th, 2010|Anti-Epileptic Drugs, Mood Stabilizers, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Anticonvulsant Use in Pregnancy and Nursing: Differences in Recommendations from Psychiatrists vs. Neurologists

There are strong parallels between the clinical management of bipolar disorder and epilepsy, and women with these disorders face significant challenges while pregnant or planning to conceive. In this setting, treatment decisions must balance the risks of recurrence of severe illness with the risks of potential harm to the fetus when certain medicines are taken during pregnancy.

By MGH Center for Women's Mental Health|2016-03-28T13:23:58-04:00February 3rd, 2010|Anti-Epileptic Drugs, Breastfeeding & Medications, Mood Stabilizers, Pregnancy & Medications|Comments Off

Prenatal Use of Atypical Antipsychotics: Effect on Birth Weight

Atypical antipsychotic medications are commonly used for the treatment of schizophrenia and bipolar disorder. Despite the increasing use of these medications in women of child-bearing age, there is still relatively little data addressing the reproductive safety of these medications.

By MGH Center for Women's Mental Health|2015-08-12T15:37:11-04:00January 25th, 2010|Antipsychotic Medications, Outcomes, Pregnancy & Medications, Pregnancy Outcomes|Comments Off

Use of the Emsam Patch (Selegiline) in Pregnancy

A clinician asks: "Is there any data on the use of the Emsam patch in pregnancy?"

By MGH Center for Women's Mental Health|2015-08-12T15:27:21-04:00December 14th, 2009|Antidepressants, Pregnancy & Medications|Comments Off

SSRIs and PPHN: A Review of the Data

In 2006, Chambers and colleagues published an article linking SSRI use during late pregnancy to an increased risk of persistent pulmonary hypertension in the newborn (PPHN). Since that time, several other reports have been published which have examined the association between SSRI antidepressants and PPHN. Here is a summary of the findings to date:

By MGH Center for Women's Mental Health|2015-08-12T15:21:36-04:00November 10th, 2009|Antidepressants, Neonatal Symptoms, Outcomes, Pregnancy & Medications|Comments Off

Lamotrigine and Pregnancy: An Update

While anticonvulsants, such as lamotrigine (Lamictal), topiramate (Topamax), and gabapentin (Neurontin), are being used with increasing regularity for the treatment of women with bipolar disorder, we have limited information with respect to the reproductive safety of the newer anticonvulsant agents. In 2006, we reported on preliminary data indicating an increased risk of oral clefts among infants exposed to lamotrigine during the first trimester of pregnancy.

By Ruta Nonacs, MD PhD|2025-06-26T09:07:11-04:00August 25th, 2009|Anti-Epileptic Drugs, Mood Stabilizers, Outcomes, Pregnancy & Medications|Comments Off