Epidemiology of the Use of Psychotropic Drugs in Pregnant and Nursing Women

  • Sura AlwanEmail author
  • Anick Bérard


At least one in ten women is exposed to a psychotropic medication in the perinatal period, and the rate has increased tremendously over the past two decades. Pregnancy is a period of extreme vulnerability to the onset of depression and other mental illnesses, and the use of pharmacological treatment has become highly concerning to patients and their healthcare providers with limited data available to assess their effectiveness to the pregnant woman and safety to her developing fetus. This has been demonstrated by the high rates of discontinuation of many psychotropic medications upon recognition of pregnancy, thereby posing a risk of relapse of the underlying condition in women with severe form of psychiatric disease, which may have adverse effects on the pregnancy and possibly on the health of the fetus as well. Antidepressants account for the majority of prescribed psychotropic medications for women in the perinatal period and are indicated for a variety of conditions, other than depression. Other commonly reported psychotropic medications among perinatal women include anxiety medications and atypical antipsychotics. Both geographical and temporal factors are important in understanding prescription trends of these medications over the perinatal period.


Pregnancy Breastfeeding Psychotropic Antidepressants Antipsychotics Anxiolytics Depression Anxiety Bipolar disorder Schizophrenia 


  1. 1.
    Kim JJ, Silver RK. Perinatal suicide associated with depression diagnosis and absence of active treatment in 15-year UK national inquiry. Evid Based Ment Health. 2016;9:122.Google Scholar
  2. 2.
    Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106:1071–83.PubMedGoogle Scholar
  3. 3.
    Vigod SN, Kurdyak PA, Dennis CL, Gruneir A, Newman A, Seeman MV, Rochon PA, Anderson GM, Grigoriadis S, Ray JG. Maternal and newborn outcomes among women with schizophrenia: a retrospective population-based cohort study. BJOG. 2014;121:566–74.PubMedGoogle Scholar
  4. 4.
    Viguera AC, Whitfield T, Baldessarini RJ, Newport DJ, Stowe Z, Reminick A, Zurick A, Cohen LS. Risk of recurrence in women with bipolar disorder during pregnancy: prospective study of mood stabilizer discontinuation. Am J Psychiatry. 2007;164:1817–24. quiz 1923.PubMedGoogle Scholar
  5. 5.
    Kornfield SL, Moseley M, Appleby D, Mcmickens CL, Sammel MD, Epperson CN. Posttraumatic symptom reporting and reported cigarette smoking during pregnancy. J Womens Health (Larchmt). 2017;26:662–9.Google Scholar
  6. 6.
    Kozhimannil KB, Pereira MA, Harlow BL. Association between diabetes and perinatal depression among low-income mothers. JAMA. 2009;301:842–7.PubMedGoogle Scholar
  7. 7.
    Zhao L, Mccauley K, Sheeran L. The interaction of pregnancy, substance use and mental illness on birthing outcomes in Australia. Midwifery. 2017;54:81–8.PubMedGoogle Scholar
  8. 8.
    Carmichael SL, Shaw GM. Maternal life event stress and congenital anomalies. Epidemiology. 2000;11:30–5.PubMedGoogle Scholar
  9. 9.
    Hansen D, Lou HC, Olsen J. Serious life events and congenital malformations: a national study with complete follow-up. Lancet. 2000;356:875–80.PubMedGoogle Scholar
  10. 10.
    Field T, Diego M, Hernandez-Reif M. Prenatal depression effects on the fetus and newborn: a review. Infant Behav Dev. 2006;29:445–55.PubMedGoogle Scholar
  11. 11.
    Grote NK, Bridge JA, Gavin AR, Melville JL, Iyengar S, Katon WJ. A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction. Arch Gen Psychiatry. 2010;67:1012–24.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Hobel CJ, Goldstein A, Barrett ES. Psychosocial stress and pregnancy outcome. Clin Obstet Gynecol. 2008;51:333–48.PubMedGoogle Scholar
  13. 13.
    Orr ST, Miller CA. Maternal depressive symptoms and the risk of poor pregnancy outcome. Review of the literature and preliminary findings. Epidemiol Rev. 1995;17:165–71.PubMedGoogle Scholar
  14. 14.
    Stevenson F, Hamilton S, Pinfold V, Walker C, Dare CR, Kaur H, Lambley R, Szymczynska P, Nicolls V, Petersen I. Decisions about the use of psychotropic medication during pregnancy: a qualitative study. BMJ Open. 2016;6:e010130.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Food Drug Administration. Content and format of labeling for human prescription drug and biological products; requirements for pregnancy and lactation labeling. Final rule. Fed Regist. 2014;79:72063–103.Google Scholar
  16. 16.
    Freeman MP. Psychotropic medication use during pregnancy: changes to the labeling system and the importance of exposure registries. J Clin Psychiatry. 2015;76:990–1.PubMedGoogle Scholar
  17. 17.
    Hancock RL, Ungar WJ, Einarson A, Koren G. International practices in the provision of teratology information: a survey of international teratogen information programmes and comparisons with the North American model. J Eval Clin Pract. 2010;16:957–63.PubMedGoogle Scholar
  18. 18.
    Schaefer C. Drug safety in pregnancy: utopia or achievable prospect? Risk information, risk research and advocacy in Teratology Information Services. Congenit Anom (Kyoto). 2011;51:6–11.Google Scholar
  19. 19.
    Chambers C. The role of teratology information services in screening for teratogenic exposures: challenges and opportunities. Am J Med Genet C Semin Med Genet. 2011;157C:195–200.PubMedGoogle Scholar
  20. 20.
    Finer LB, Zolna MR. Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception. 2011;84:478–85.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Mcallister-Williams RH, Baldwin DS, Cantwell R, Easter A, Gilvarry E, Glover V, Green L, Gregoire A, Howard LM, Jones I, Khalifeh H, Lingford-Hughes A, Mcdonald E, Micali N, Pariante CM, Peters L, Roberts A, Smith NC, Taylor D, Wieck A, Yates LM, Young AH. British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017. J Psychopharmacol. 2017;31:519–52.PubMedGoogle Scholar
  22. 22.
    Smith B, Dubovsky SL. Pharmacotherapy of mood disorders and psychosis in pre- and post-natal women. Expert Opin Pharmacother. 2017;18:1703–19.PubMedGoogle Scholar
  23. 23.
    Hanley GE, Mintzes B. Patterns of psychotropic medicine use in pregnancy in the United States from 2006 to 2011 among women with private insurance. BMC Pregnancy Childbirth. 2014;14:242.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Grigoriadis S, Robinson GE. Gender issues in depression. Ann Clin Psychiatry. 2007;19:247–55.PubMedGoogle Scholar
  25. 25.
    Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol. 2004;103:698–709.Google Scholar
  26. 26.
    Cohen LS, Altshuler LL, Harlow BL, Nonacs R, Newport DJ, Viguera AC, Suri R, Burt VK, Hendrick V, Reminick AM, Loughead A, Vitonis AF, Stowe ZN. Relapse of major depression during pregnancy in women who maintain or discontinue antidepressant treatment. JAMA. 2006;295:499–507.PubMedGoogle Scholar
  27. 27.
    Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004;26:289–95.PubMedGoogle Scholar
  28. 28.
    National Center for Health Statistics. Health, United States, 2016: with chartbook on long-term trends in health. Hyattsville, MD: National Center for Health Statistics; 2017.Google Scholar
  29. 29.
    Alwan S, Reefhuis J, Rasmussen SA, Friedman JM. Patterns of antidepressant medication use among pregnant women in a United States population. J Clin Pharmacol. 2011;51:264–70.PubMedGoogle Scholar
  30. 30.
    Andrade SE, Raebel MA, Brown J, Lane K, Livingston J, Boudreau D, Rolnick SJ, Roblin D, Smith DH, Willy ME, Staffa JA, Platt R. Use of antidepressant medications during pregnancy: a multisite study. Am J Obstet Gynecol. 2008;198:194.e1–5.Google Scholar
  31. 31.
    Berard A, Ramos E, Rey E, Blais L, St. Andre M, Oraichi D. First trimester exposure to paroxetine and risk of cardiac malformations in infants: the importance of dosage. Birth Defects Res B Dev Reprod Toxicol. 2007;80:18–27.PubMedGoogle Scholar
  32. 32.
    Huybrechts KF, Palmsten K, Mogun H, Kowal M, Avorn J, Setoguchi-Iwata S, Hernandez-Diaz S. National trends in antidepressant medication treatment among publicly insured pregnant women. Gen Hosp Psychiatry. 2013;35:265–71.PubMedPubMedCentralGoogle Scholar
  33. 33.
    Jimenez-Solem E, Andersen JT, Petersen M, Broedbaek K, Andersen NL, Torp-Pedersen C, Poulsen HE. Prevalence of antidepressant use during pregnancy in Denmark, a nation-wide cohort study. PLoS One. 2013;8:e63034.PubMedPubMedCentralGoogle Scholar
  34. 34.
    Ramos E, Oraichi D, Rey E, Blais L, Berard A. Prevalence and predictors of antidepressant use in a cohort of pregnant women. BJOG. 2007;114:1055–64.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Ververs T, Kaasenbrood H, Visser G, Schobben F, De Jong-Van Den Berg L, Egberts T. Prevalence and patterns of antidepressant drug use during pregnancy. Eur J Clin Pharmacol. 2006;62:863.PubMedGoogle Scholar
  36. 36.
    Petersen I, Gilbert RE, Evans SJ, Man SL, Nazareth I. Pregnancy as a major determinant for discontinuation of antidepressants: an analysis of data from The Health Improvement Network. J Clin Psychiatry. 2011;72:979–85.PubMedGoogle Scholar
  37. 37.
    Cooper WO, Willy ME, Pont SJ, Ray WA. Increasing use of antidepressants in pregnancy. Am J Obstet Gynecol. 2007;196:544.e1–5.Google Scholar
  38. 38.
    Bakker MK, Kölling P, Van Den Berg PB, De Walle HE, De Jong Van Den Berg LT. Increase in use of selective serotonin reuptake inhibitors in pregnancy during the last decade, a population-based cohort study from the Netherlands. Br J Clin Pharmacol. 2008;65:600–6.PubMedGoogle Scholar
  39. 39.
    Harman JS, Edlund MJ, Fortney JC. Trends in antidepressant utilization from 2001 to 2004. Psychiatr Serv. 2009;60:611–6.PubMedGoogle Scholar
  40. 40.
    Morrison JL, Riggs KW, Rurak DW. Fluoxetine during pregnancy: impact on fetal development. Reprod Fertil Dev. 2005;17:641–50.PubMedGoogle Scholar
  41. 41.
    Hiemke C, Hartter S. Pharmacokinetics of selective serotonin reuptake inhibitors. Pharmacol Ther. 2000;85:11–28.PubMedGoogle Scholar
  42. 42.
    Alwan S, Reefhuis J, Rasmussen SA, Olney RS, Friedman JM. Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects. New Engl J Med. 2007;356:2684–92.PubMedGoogle Scholar
  43. 43.
    Berard A, Zhao JP, Sheehy O. Antidepressant use during pregnancy and the risk of major congenital malformations in a cohort of depressed pregnant women: an updated analysis of the Quebec Pregnancy Cohort. BMJ Open. 2017;7:e013372.PubMedPubMedCentralGoogle Scholar
  44. 44.
    Cole JA, Ephross SA, Cosmatos IS, Walker AM. Paroxetine in the first trimester and the prevalence of congenital malformations. Pharmacoepidemiol Drug Saf. 2007;16:1075–85.PubMedGoogle Scholar
  45. 45.
    Louik C, Lin AE, Werler MM, Hernandez-Diaz S, Mitchell AA. First-trimester use of selective serotonin-reuptake inhibitors and the risk of birth defects. New Engl J Med. 2007;356:2675–83.PubMedGoogle Scholar
  46. 46.
    Wogelius P, Norgaard M, Gislum M, Pedersen L, Munk E, Mortensen PB, Lipworth L, Sorensen HT. Maternal use of selective serotonin reuptake inhibitors and risk of congenital malformations. Epidemiology. 2006;17:701–14.PubMedGoogle Scholar
  47. 47.
    Chambers CD, Johnson KA, Dick LM, Felix RJ, Jones KL. Birth outcomes in pregnant women taking fluoxetine. N Engl J Med. 1996;335:1010–5.PubMedGoogle Scholar
  48. 48.
    Costei AM, Kozer E, Ho T, Ito S, Koren G. Perinatal outcome following third trimester exposure to paroxetine. Arch Pediatr Adolesc Med. 2002;156:1129–32.PubMedGoogle Scholar
  49. 49.
    Ferreira E, Carceller AM, Agogue C, Martin BZ, ST. Andre M, Francoeur D, Berard A. Effects of selective serotonin reuptake inhibitors and venlafaxine during pregnancy in term and preterm neonates. Pediatrics. 2007;119:52–9.PubMedGoogle Scholar
  50. 50.
    Kallen B. Neonate characteristics after maternal use of antidepressants in late pregnancy. Arch Pediatr Adolesc Med. 2004;158:307–8.Google Scholar
  51. 51.
    Oberlander TF, Warburton W, Misri S, Aghajanian J, Hertzman C. Neonatal outcomes after prenatal exposure to selective serotonin reuptake inhibitor antidepressants and maternal depression using population-based linked health data. Arch Gen Psychiatry. 2006;63:898–906.PubMedGoogle Scholar
  52. 52.
    Andrade SE, Mcphillips H, Loren D, Raebel MA, Lane K, Livingston J, Boudreau DM, Smith DH, Davis RL, Willy ME, Platt R. Antidepressant medication use and risk of persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf. 2009;18:246–52.PubMedGoogle Scholar
  53. 53.
    Chambers CD, Hernandez-Diaz S, Van Marter LJ, Werler MM, Louik C, Jones KL, Mitchell AA. Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. N Engl J Med. 2006;354:579–87.PubMedGoogle Scholar
  54. 54.
    Huybrechts KF, Bateman BT, Hernandez-Diaz S. Maternal antidepressant use and persistent pulmonary hypertension of the newborn--Reply. JAMA. 2015;314:1294.PubMedGoogle Scholar
  55. 55.
    Kieler H, Artama M, Engeland A, Ericsson O, Furu K, Gissler M, Nielsen RB, Norgaard M, Stephansson O, Valdimarsdottir U, Zoega H, Haglund B. Selective serotonin reuptake inhibitors during pregnancy and risk of persistent pulmonary hypertension in the newborn: population based cohort study from the five Nordic countries. BMJ. 2012;344:d8012.PubMedGoogle Scholar
  56. 56.
    Casper RC, Fleisher BE, Lee-Ancajas JC, Gilles A, Gaylor E, Debattista A, Hoyme HE. Follow-up of children of depressed mothers exposed or not exposed to antidepressant drugs during pregnancy. J Pediatr. 2003;142:402–8.PubMedGoogle Scholar
  57. 57.
    Cohen LS, Heller VL, Bailey JW, Grush L, Ablon JS, Bouffard SM. Birth outcomes following prenatal exposure to fluoxetine. Biol Psychiatry. 2000;48:996–1000.PubMedGoogle Scholar
  58. 58.
    Malm H, Klaukka T, Neuvonen PJ. Risks associated with selective serotonin reuptake inhibitors in pregnancy. Obstet Gynecol. 2005;106:1289–96.PubMedGoogle Scholar
  59. 59.
    Boukhris T, Sheehy O, Mottron L, Berard A. Antidepressant use during pregnancy and the risk of autism spectrum disorder in children. JAMA Pediatr. 2016;170:117–24.PubMedGoogle Scholar
  60. 60.
    Croen LA, Grether JK, Yoshida CK, Odouli R, Hendrick V. Antidepressant use during pregnancy and childhood autism spectrum disorders. Arch Gen Psychiatry. 2011;68:1104–12.PubMedGoogle Scholar
  61. 61.
    Gidaya NB, Lee BK, Burstyn I, Yudell M, Mortensen EL, Newschaffer CJ. In utero exposure to selective serotonin reuptake inhibitors and risk for autism spectrum disorder. J Autism Dev Disord. 2014;44:2558–67.PubMedGoogle Scholar
  62. 62.
    Harrington RA, Lee LC, Crum RM, Zimmerman AW, Hertz-Picciotto I. Prenatal SSRI use and offspring with autism spectrum disorder or developmental delay. Pediatrics. 2014;133:e1241–8.PubMedPubMedCentralGoogle Scholar
  63. 63.
    Sorensen MJ, Gronborg TK, Christensen J, Parner ET, Vestergaard M, Schendel D, Pedersen LH. Antidepressant exposure in pregnancy and risk of autism spectrum disorders. Clin Epidemiol. 2013;5:449–59.PubMedPubMedCentralGoogle Scholar
  64. 64.
    Charlton RA, Jordan S, Pierini A, Garne E, Neville AJ, Hansen AV, Gini R, Thayer D, Tingay K, Puccini A, Bos HJ, Nybo Andersen AM, Sinclair M, Dolk H, De Jong-Van Den Berg LT. Selective serotonin reuptake inhibitor prescribing before, during and after pregnancy: a population-based study in six European regions. BJOG. 2015;122:1010–20.PubMedGoogle Scholar
  65. 65.
    Kallen B, Borg N, Reis M. The use of central nervous system active drugs during pregnancy. Pharmaceuticals. 2013;6:1221–86.PubMedPubMedCentralGoogle Scholar
  66. 66.
    Ban L, Gibson JE, West J, Fiaschi L, Sokal R, Smeeth L, Doyle P, Hubbard RB, Tata LJ. Maternal depression, antidepressant prescriptions, and congenital anomaly risk in offspring: a population-based cohort study. BJOG. 2014;121:1471–81.PubMedPubMedCentralGoogle Scholar
  67. 67.
    Orsolini L, Bellantuono C. Serotonin reuptake inhibitors and breastfeeding: a systematic review. Hum Psychopharmacol. 2015;30:4–20.PubMedGoogle Scholar
  68. 68.
    Ascher JA, Cole JO, Colin JN, Feighner JP, Ferris RM, Fibiger HC, Golden RN, Martin P, Potter WZ, Richelson E, et al. Bupropion: a review of its mechanism of antidepressant activity. J Clin Psychiatry. 1995;56:395–401.PubMedGoogle Scholar
  69. 69.
    Tong VT, England LJ, Dietz PM, Asare LA. Smoking patterns and use of cessation interventions during pregnancy. Am J Prev Med. 2008;35:327–33.PubMedGoogle Scholar
  70. 70.
    Berard A, Zhao JP, Sheehy O. Success of smoking cessation interventions during pregnancy. Am J Obstet Gynecol. 2016;215:611.e1–8.Google Scholar
  71. 71.
    Alwan S, Reefhuis J, Botto LD, Rasmussen SA, Correa A, Friedman JM. Maternal use of bupropion and risk for congenital heart defects. Am J Obstet Gynecol. 2010;203:52.e1–6.Google Scholar
  72. 72.
    Louik C, Kerr S, Mitchell AA. First-trimester exposure to bupropion and risk of cardiac malformations. Pharmacoepidemiol Drug Saf. 2014;23:1066–75.PubMedGoogle Scholar
  73. 73.
    Thyagarajan V, Robin Clifford C, Wurst KE, Ephross SA, Seeger JD. Bupropion therapy in pregnancy and the occurrence of cardiovascular malformations in infants. Pharmacoepidemiol Drug Saf. 2012;21:1240–2.PubMedGoogle Scholar
  74. 74.
    Ter Horst PG, Van Der Linde S, Smit JP, Den Boon J, Van Lingen RA, Jansman FG, De Jong-Van Den Berg LT, Wilffert B. Clomipramine concentration and withdrawal symptoms in 10 neonates. Br J Clin Pharmacol. 2012;73:295–302.PubMedPubMedCentralGoogle Scholar
  75. 75.
    Boukhris T, Sheehy O, Berard A. Antidepressant use in pregnancy and the risk of attention deficit with or without hyperactivity disorder in children. Paediatr Perinat Epidemiol. 2017;31:363–73.PubMedGoogle Scholar
  76. 76.
    Einarson A, Fatoye B, Sarkar M, Lavigne SV, Brochu J, Chambers C, Mastroiacovo P, Addis A, Matsui D, Schuler L, Einarson TR, Koren G. Pregnancy outcome following gestational exposure to venlafaxine: a multicenter prospective controlled study. Am J Psychiatry. 2001;158:1728–30.PubMedGoogle Scholar
  77. 77.
    Lennestal R, Kallen B. Delivery outcome in relation to maternal use of some recently introduced antidepressants. J Clin Psychopharmacol. 2007;27:607–13.PubMedGoogle Scholar
  78. 78.
    Nakhai-Pour HR, Broy P, Berard A. Use of antidepressants during pregnancy and the risk of spontaneous abortion. CMAJ. 2010;182:1031–7.PubMedPubMedCentralGoogle Scholar
  79. 79.
    Iqbal MM, Sobhan T, Ryals T. Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant. Psychiatr Serv. 2002;53:39–49.PubMedGoogle Scholar
  80. 80.
    Mcelhatton PR. The effects of benzodiazepine use during pregnancy and lactation. Reprod Toxicol. 1994;8:461–75.PubMedGoogle Scholar
  81. 81.
    Alexander GC, Gallagher SA, Mascola A, Moloney RM, Stafford RS. Increasing off-label use of antipsychotic medications in the United States, 1995-2008. Pharmacoepidemiol Drug Saf. 2011;20:177–84.PubMedPubMedCentralGoogle Scholar
  82. 82.
    Olfson M, Blanco C, Liu SM, Wang S, Correll CU. National trends in the office-based treatment of children, adolescents, and adults with antipsychotics. Arch Gen Psychiatry. 2012;69:1247–56.PubMedGoogle Scholar
  83. 83.
    Toh S, Li Q, Cheetham TC, Cooper WO, Davis RL, Dublin S, Hammad TA, Li DK, Pawloski PA, Pinheiro SP, Raebel MA, Scott PE, Smith DH, Bobo WV, Lawrence JM, Dashevsky I, Haffenreffer K, Avalos LA, Andrade SE. Prevalence and trends in the use of antipsychotic medications during pregnancy in the U.S., 2001-2007: a population-based study of 585,615 deliveries. Arch Womens Ment Health. 2013;16:149–57.PubMedPubMedCentralGoogle Scholar
  84. 84.
    Coughlin CG, Blackwell KA, Bartley C, Hay M, Yonkers KA, Bloch MH. Obstetric and neonatal outcomes after antipsychotic medication exposure in pregnancy. Obstet Gynecol. 2015;125:1224–35.PubMedPubMedCentralGoogle Scholar
  85. 85.
    Terrana N, Koren G, Pivovarov J, Etwel F, Nulman I. Pregnancy outcomes following in utero exposure to second-generation antipsychotics: a systematic review and meta-analysis. J Clin Psychopharmacol. 2015;35:559–65.PubMedGoogle Scholar
  86. 86.
    Johnson KC, Laprairie JL, Brennan PA, Stowe ZN, Newport DJ. Prenatal antipsychotic exposure and neuromotor performance during infancy. Arch Gen Psychiatry. 2012;69:787–94.PubMedPubMedCentralGoogle Scholar
  87. 87.
    Peng M, Gao K, Ding Y, Ou J, Calabrese JR, Wu R, Zhao J. Effects of prenatal exposure to atypical antipsychotics on postnatal development and growth of infants: a case-controlled, prospective study. Psychopharmacology (Berl). 2013;228:577–84.Google Scholar
  88. 88.
    Lin HC, Chen IJ, Chen YH, Lee HC, Wu FJ. Maternal schizophrenia and pregnancy outcome: does the use of antipsychotics make a difference? Schizophr Res. 2010;116:55–60.PubMedGoogle Scholar
  89. 89.
    Habermann F, Fritzsche J, Fuhlbruck F, Wacker E, Allignol A, Weber-Schoendorfer C, Meister R, Schaefer C. Atypical antipsychotic drugs and pregnancy outcome: a prospective, cohort study. J Clin Psychopharmacol. 2013;33:453–62.PubMedGoogle Scholar
  90. 90.
    Patton SW, Misri S, Corral MR, Perry KF, Kuan AJ. Antipsychotic medication during pregnancy and lactation in women with schizophrenia: evaluating the risk. Can J Psychiatry. 2002;47:959–65.PubMedGoogle Scholar
  91. 91.
    Park Y, Huybrechts KF, Cohen JM, Bateman BT, Desai RJ, Patorno E, Mogun H, Cohen LS, Hernandez-Diaz S. Antipsychotic medication use among publicly insured pregnant women in the United States. Psychiatr Serv. 2017;68:1112–9.PubMedPubMedCentralGoogle Scholar
  92. 92.
    Margulis AV, Kang EM, Hammad TA. Patterns of prescription of antidepressants and antipsychotics across and within pregnancies in a population-based UK cohort. Matern Child Health J. 2014;18:1742–52.PubMedGoogle Scholar
  93. 93.
    Reis M, Kallen B. Maternal use of antipsychotics in early pregnancy and delivery outcome. J Clin Psychopharmacol. 2008;28:279–88.PubMedGoogle Scholar
  94. 94.
    Newport DJ, Calamaras MR, Devane CL, Donovan J, Beach AJ, Winn S, Knight BT, Gibson BB, Viguera AC, Owens MJ, Nemeroff CB, Stowe ZN. Atypical antipsychotic administration during late pregnancy: placental passage and obstetrical outcomes. Am J Psychiatry. 2007;164:1214–20.PubMedGoogle Scholar
  95. 95.
    Boden R, Lundgren M, Brandt L, Reutfors J, Andersen M, Kieler H. Risks of adverse pregnancy and birth outcomes in women treated or not treated with mood stabilisers for bipolar disorder: population based cohort study. BMJ. 2012;345:e7085.PubMedPubMedCentralGoogle Scholar
  96. 96.
    Cohen LS, Friedman JM, Jefferson JW, Johnson EM, Weiner ML. A reevaluation of risk of in utero exposure to lithium. JAMA. 1994;271:146–50.PubMedGoogle Scholar
  97. 97.
    Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Sabers A, Perucca E, Vajda F. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. Lancet Neurol. 2011;10:609–17.PubMedGoogle Scholar
  98. 98.
    Wisner KL, Perel JM. Serum levels of valproate and carbamazepine in breastfeeding mother-infant pairs. J Clin Psychopharmacol. 1998;18:167–9.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Medical GeneticsUniversity of British ColumbiaVancouverCanada
  2. 2.Faculty of Pharmacy, CHU Sainte-Justine Research CenterUniversity of MontrealMontrealCanada

Personalised recommendations