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P0248 - Psychotropic drugs in pregnancy and lactation. Clinical aspects

Published online by Cambridge University Press:  16 April 2020

S. Gentile
S. Gentile*
Affiliation:
Department of Mental Health Operative Unit N. 4, Cava de' Tirreni, Salerno, Italy

Abstract

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This presentation is focused to analyse the safety of SSRIs and mood stabilisers in pregnancy and breastfeeding in order to reduce the risks associated with pre- and postnatal exposure to both classes of psychotropic drugs.

SSRIs

Recent literature information seems to suggest that SSRIs as group, sertraline, and, especially, paroxetine, may be associated with an increased risk of fetal malformations (cardiovascular anomalies, prevalently).

Moreover, exposure to such agents late in pregnancy is associated with an increased risk of inducing neonatal complications.

Further, the repercussions of SSRI exposure through placenta on the infant's neuropsychological development remain substantially unknown.

On the other hand, only sporadic case-reports have described unwanted reactions (of low degree of severity, however) in infants breastfed by mothers who were treated with SSRIs during lactation.

(1) Classic and emergent mood stabilizers

Classic mood stabilizers have been associated with an increased risk of fetal major malformations.

As regards atypical antipsychotics, available data are still insufficient to confirm or exclude an intrinsic teratogenic potential.(2) Conversely, information on lamotrigine seems to be quite reassuring.

Placental exposure to valproate is also associated with impaired neurodevelopmental outcomes.

Finally, all mood stabilising agents show too limited data for suggesting their safe use in lactation.

Type
Poster Session III: Miscellaneous
Information
European Psychiatry , Volume 23 , Issue S2: 16th AEP Congress - Abstract book - 16th AEP Congress , April 2008 , pp. S373
Copyright
Copyright © European Psychiatric Association 2008

References

Gentile, S. Use of contemporary antidepressants during breastfeeding. A proposal for a specific safety index. Drug Saf 2007;30(2):107–121.10.2165/00002018-200730020-00002CrossRefGoogle ScholarPubMed
Gentile, S. Prophylactic treatment of bipolar disorder in pregnancy and breastfeeding: focus on emerging mood stabilizers. Bipolar Disord 2006;8(3):207–220.10.1111/j.1399-5618.2006.00295.xCrossRefGoogle ScholarPubMed
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