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Psychopharmakotherapie und psychiatrische Begleitung in Schwangerschaft und Stillzeit

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Psychiatrie, Psychosomatik, Psychotherapie

Zusammenfassung

Die Behandlung psychisch kranker Frauen in Schwangerschaft und Stillzeit ist eine eher seltene Aufgabe für Psychiater; vielleicht ist das der Grund dafür, dass Unsicherheit vonseiten des Arztes eine typische Reaktion ist. Wir haben alle aufgrund der Contergan-Affäre in den 1960er-Jahren gelernt, welch gravierende Probleme teratogene Substanzen verursachen können. Ein verantwortlicher Umgang mit Psychopharmaka in der Schwangerschaft ist die erfreuliche Konsequenz dieser Erfahrungen. Andererseits aber gibt es auch immer wieder Situationen, in denen vorschnelles Handeln – wie etwa das ungerechtfertigte Absetzen einer bewährten Medikation bei Kinderwunsch oder Feststellung einer Schwangerschaft – eine Patientin psychisch destabilisieren kann. Stattdessen ermöglicht eine qualifizierte Beratung der Patientin und ihres Partners eine informierte Entscheidung der Betroffenen. Die psychiatrische Betreuung im Falle einer Schwangerschaft sollte eine möglichst positive Erfahrung von Schwangerschaft und Entbindung zum Ziel haben. Die Prinzipien der Behandlung von psychisch kranken schwangeren Frauen und Frauen, für die die Familienplanung noch nicht abgeschlossen ist, werden hier dargestellt, ergänzt durch Informationen zum peripartalen Management und zur Stillzeit.

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Schaefer, C., Dorsch, V., Rohde, A. (2017). Psychopharmakotherapie und psychiatrische Begleitung in Schwangerschaft und Stillzeit. In: Möller, HJ., Laux, G., Kapfhammer, HP. (eds) Psychiatrie, Psychosomatik, Psychotherapie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49295-6_90

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