Meyers , Kimberly
Background: Medication use in pregnancy walks a fine line between safety of the mother and adverse effects in the developing fetus. Medications are prescribed to either help the mother maintain mental stability or they are discontinued out of fear of fetal harm. Many providers hope that the shift in hormones during pregnancy will fulfill the medications requirement in the non-pregnant state but this is not always the case. Is a discontinuation in medications upon a positive pregnancy test warranted? Purpose: To determine if antipsychotics, mood stabilizers, and antidepressants should be continued or discontinued during pregnancy or if they negatively impact the fetus/neonate development, maternal wellbeing, and/or maternal-fetal interactions. Results: Continuation of medications has a high correlation with adverse fetal effects as well as adverse maternal metabolic syndromes. Discontinuation of medications has a high correlation with maternal relapse and adverse fetal effects due to maternal illness. More research is needed to be able to fully assess the safety of antidepressants, antipsychotics and mood stabilizers in pregnancy. Conclusion: Midwifery care is helpful to patients in understanding all their options while taking medications in the antidepressant, antipsychotic, and mood stabilizing families during pregnancy. Each situation and patient need to be treated individually and care needs to be patient based. Midwives must educate patients and help them to make an informed choice as to continuing or discontinuing psychotropic medications during pregnancy. Implications for Research and Practice: Careful consideration needs to be given based on each diagnosis and situation. Some situations may call for a discontinuation of medications while others indicate continuation for best outcomes. Education and current research is more important than fear of liability and current trends.
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Schultz, B. K. (2016). The Potential Benefits and Risks of Antidepressant, Antipsychotic and/or Mood Stabilizing Medications Use in Pregnancy: A Critical Review of the Literature [Masterʼs thesis, Bethel University]. Spark Repository. https://spark.bethel.edu/etd/572