Skip to main content

Psychopharmacological Treatment of Mood and Anxiety Disorders During Pregnancy

  • Chapter
  • First Online:
Sex and Gender Differences in Pharmacology

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 214))

Abstract

Many women with psychiatric disorders want to become mothers and only a minority seek advise prior to becoming pregnant. In those women, in whom pregnancy can be planned, the decision, if a medication is required for stabilisation and which one to choose if this is the case, is easier to make than in women in whom pregnancy occurs unplanned. The physician has to weigh the risk that a relapse of the psychiatric disorder during pregnancy poses to the foetus against the reproductive risk of psychotropic drugs. This presentation is intended to assist in understanding the general principles of pharmacotherapy during pregnancy as well as the morphological, perinatal and neurobehavioural toxicity of antidepressants, antipsychotics, benzodiazepines and mood stabilisers.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Alwan S, Reefhuis J, Rasmussen SA (2007) Use of selective serotonin-reuptake inhibitors in pregnancy and the risk of birth defects. N Engl J Med 356:2684–2692

    Article  PubMed  CAS  Google Scholar 

  • American Medical Association (AMA), Drug interactions and adverse drug reactions. In: AMA Drug Evaluations, AMA, Chicago; pp: 31–44, 1983.

    Google Scholar 

  • Ananth J (1976) Side effects on fetus and infant of psychotropic drug use during pregnancy. Int Pharmacopsychiatry 11:246–260

    PubMed  CAS  Google Scholar 

  • Arora M, Praharaj SK (2006) Meningocele and ankyloblepharon following in utero exposure to olanzapine. Eur Psychiatry 21:341–346

    Article  Google Scholar 

  • Artama M, Ritvanen A, Gissler M, Isojärvi J, Auvinen A (2005) Congenital structural anomalies in offspring of women with epilepsy–a population-based cohort study in Finland. Int J Epidemiol 35(2):280–287

    Article  PubMed  Google Scholar 

  • Bardy AH, Lillsunde P, Hiilesmaa VK, Seppälä T (1994) Objectively measured perinatal exposure to meperidine and benzodiazepines in Finland. Clin Pharmacol Ther 55(4):471–476

    Article  PubMed  CAS  Google Scholar 

  • Barnas C, Bergant A, Hummer M, Saria A, Fleischhacker WW (1994) Clozapine concentrations in maternal and fetal plasma, amniotic fluid, and breast milk [letter]. Am J Psychiatry 151:945

    PubMed  CAS  Google Scholar 

  • Bar-Oz B, Einarson T, Einarson A (2007) Paroxetine and congenital malformations: meta-analysis and consideration of potential confounding factors. Clin Ther 29:918–926

    Article  PubMed  CAS  Google Scholar 

  • Barr JA, Beck CT (2008) Infanticide secrets: qualitative study on postpartum depression. Can Fam Physician 54(12):1716–1717.e5

    PubMed  Google Scholar 

  • Birnbaum CS, Cohen LS, Bailey JW, Grush LR, Robertson LM, Stowe ZN (1999) Serum concentrations of antidepressants and benzodiazepines in nursing infants: a case series. Pediatrics 104(1):e 111

    Article  Google Scholar 

  • Biswas PN, Wilton LV, Pearce GL, Freehahtle S, Shakir SA (2001) The pharmacovigilance of olanzapine: results of a post-marketing surveillance study on 8858 patients in England. J Psychopharmacol 15:265–271

    Article  CAS  Google Scholar 

  • Bromley RL, Baker GA, Meador KJ (2009) Cognitive abilities and behaviour of children exposed to antiepileptic drugs in utero. Curr Opin Neurol 22(2):162–166

    Article  PubMed  CAS  Google Scholar 

  • Cabuk D, Sayin A, Derinöz O, Biri A (2007) Quetiapine use for the treatment of manic episode during pregnancy. Arch Womens Ment Health 10:235–236, 86

    Article  PubMed  CAS  Google Scholar 

  • Cattaruzza MS, Spinelli A (2000) Spontaneous abortion in Italy: social differences and temporal trends. Epidemiol Prev 24(4):166–171

    PubMed  CAS  Google Scholar 

  • Chambers C (2012) Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: a prospective study. Alcohol Clin Exp Res 168(11):1179–1185, 1

    Google Scholar 

  • Chambers CD, Johnson KA, Dick LM, Felix RJ, Jones KL (1996) Birth outcomes in pregnant women taking fluoxetine. N Engl J Med 335(14):1010–1015

    Article  PubMed  CAS  Google Scholar 

  • Chambers CD, Hernandez-Diaz S, van Marter LJ et al (2006) Selective serotonin-reuptake inhibitors and risk of persistent pulmonary hypertension of the newborn. N Engl J Med 354(6):579–587

    Article  PubMed  CAS  Google Scholar 

  • Charlton RA, Weil JG, Cunnington MC, Ray S, de Vries CS (2011) Comparing the General Practice Research Database and the UK Epilepsy and Pregnancy Register as tools for postmarketing teratogen surveillance: anticonvulsants and the risk of major congenital malformations. Drug Saf 34(2):157–171

    Article  PubMed  Google Scholar 

  • Cohen LS, Friedman JM, Jefferson JW, Johnson EM, Weiner ML (1994) A reevaluation of risk of in utero exposure to lithium. JAMA 271:146–150

    Article  PubMed  CAS  Google Scholar 

  • Cohen MJ, Meador KJ, Browning N, Baker GA, Clayton-Smith J, Kalayjian LA, Kanner A, Balke LD (2001). Quetiapine is effective in the treatment of bipolar affective disorder during pregnancy. Poster session presented at: 7th World Congress of Biological Psychiatry; July 1–6. Berlin, Germany

    Google Scholar 

  • Coppola D, Russo LJ, Kwarta RF Jr, Varughese S, Schmider J (2007) Evaluating the postmarketing experience of risperidone use during pregnancy. Pregnancy and neonatal outcomes. Drug Saf 30:247–264

    Article  PubMed  CAS  Google Scholar 

  • Costei AM, Kozer E, Ho T, Ito S, Koren G (2002) Perinatal outcome following third trimester exposure to paroxetine. Arch Pediatr Adolesc Med 156(11):1129–1132

    PubMed  Google Scholar 

  • Craig JJ, Gray WJ, McCann JP (1999) The Chiari/hydrosyringomyelia complex presenting in adults with myelomeningocoele: an indication for early intervention. Spinal Cord 37(4):275–278

    Article  PubMed  CAS  Google Scholar 

  • Cummings C, Stewart M, Stevenson M, Morrow J, Nelson J (2011) Neurodevelopment of children exposed in utero to lamotrigine, sodium valproate and carbamazepine. Arch Dis Child 96(7):643–647

    Article  PubMed  Google Scholar 

  • Cunnington MC, Tennis P, Committee ILPRSA (2005) Lamotrigine and the risk of malformations in pregnancy. Neurology 64:955–960

    Article  PubMed  CAS  Google Scholar 

  • Cunnington MC, Weil JG, Messenheimer JA, Ferber S, Yerby M, Tennis P (2011) Final results from 18 years of the International Lamotrigine Pregnancy Registry. Neurology 76(21):1817–1823

    Article  PubMed  CAS  Google Scholar 

  • Cunnington MC, Weil JG, Messenheimer JA, Ferber S, Yerby M, Tennis P (2011 ) Neurology. 76(21):1817–1823

    Google Scholar 

  • Cupit GC, Rotmensch HH (1985) Principles of drug therapy in pregnancy. In: Gleicher N (ed) Principles of medical therapy in pregnancy. Plenum Press, New York, pp 77–90

    Chapter  Google Scholar 

  • Czeizel AE (2011) Periconceptional folic acid-containing multivitamin supplementation for the prevention of neural tube defects and cardiovascular malformations. Ann Nutr Metab 59(1):38–40

    Article  PubMed  CAS  Google Scholar 

  • Dalmizrak O, Kulaksiz-Erkmen G, Ozer N (2011) The inhibition characteristics of human placental glutathione S-transferase-π by tricyclic antidepressants: amitriptyline and clomipramine. Mol Cell Biochem 355(1–2):223–231

    Article  PubMed  CAS  Google Scholar 

  • De Santis M, De Luca C, Mappa I, Cesari E, Quattrocchi T, Spagnuolo T, Visconti D, Caruso A (2011) Antiepileptic drugs during pregnancy: pharmacokinetics and transplacental transfer. Curr Pharm Biotechnol 12(5):781–788, Review

    PubMed  Google Scholar 

  • De Wals P, Tairou F, Van Allen MI, Uh SH, Lowry RB, Sibbald B, Evans JA, Van den Hof MC, Zimmer P, Crowley M, Fernandez B, Lee NS, Niyonsenga T (2007) Reduction in neural-tube defects after folic acid fortification in Canada. N Engl J Med 357(2):135–142

    Article  PubMed  Google Scholar 

  • De Wals P, Van Allen MI, Lowry RB, Evans JA, Van den Hof MC, Crowley M, Tairou F, Uh SH, Sibbald B, Zimmer P, Fernandez B, Lee NS, Niyonsenga T (2008a) Impact of folic acid food fortification on the birth prevalence of lipomyelomeningocele in Canada. Birth Defects Res A Clin Mol Teratol 82(2):106–109

    Article  PubMed  CAS  Google Scholar 

  • De Wals P, Tairou F, Van Allen MI, Lowry RB, Evans JA, Van den Hof MC, Crowley M, Uh SH, Zimmer P, Sibbald B, Fernandez B, Lee NS, Niyonsenga T (2008b) Spina bifida before and after folic acid fortification in Canada. Birth Defects Res A Clin Mol Teratol 82(9):622–626

    Article  PubMed  CAS  Google Scholar 

  • Di Michele V, Ramenghi LA, Sabatino G (1996) Clozapine and lorazepam administration in pregnancy [letter]. Eur Psychiatry 11:214

    Article  PubMed  Google Scholar 

  • Diav-Citrin O, Ornoy A (2012). Selective serotonin reuptake inhibitors in human pregnancy: to treat or not to treat? Obstet Gynecol Int. (epub ahead of print)

    Google Scholar 

  • Diav-Citrin O, Shechtman S, Ornoy S et al (2005) Safety of haloperidol and penfluridol in pregnancy: a multicenter, prospective, controlled study. J Clin Psychiatry 66:317–322

    Article  PubMed  CAS  Google Scholar 

  • Diav-Citrin O, Shechtman S, Weinbaum D (2008) Paroxetine and fluoxetine in pregnancy: a prospective, multicentre, controlled, observational study. Br J Clin Pharmacol 66(5):695–705

    PubMed  CAS  Google Scholar 

  • Duran A, Ugur MM, Turan S, Emuk M (2008) Clozapine use in two women with schizophrenia during pregnancy. J Psychopharmacol 22:111–113

    Article  PubMed  CAS  Google Scholar 

  • Einarson TR, Einarson A (2005) Newer antidepressants in pregnancy and rates of major malformations: a meta-analysis of prospective comparative studies. Pharmacoepidemiol Drug Saf 14:823–827

    Article  PubMed  CAS  Google Scholar 

  • Einarson A, Pistelli A, DeSantis M (2008) Evaluation of the risk of congential cardiovascular defects associated with use of paroxetine during pregnancy. Am J Psychiatry 165:749–752

    Article  PubMed  Google Scholar 

  • Ericson A, Kallen B, Wiholm BE (1999) Delivery outcome after the use of antidepressants in early pregnancy. Eur J Clin Pharmacol 55:503–508

    Article  PubMed  CAS  Google Scholar 

  • Frey B, Schubiger G, Musy J (1990) Transient cholestatic hepatitis in a neonate associated with carbamazepine exposure during pregnancy and breastfeeding. Eur J Pediatr 150:136–138

    Article  PubMed  CAS  Google Scholar 

  • Gentile S (2006) Quetiapine-fluvoxamine combination during pregnancy and while breastfeeding [letter]. Arch Womens Ment Health 9:158–159

    Article  PubMed  CAS  Google Scholar 

  • Gentile S (2010) Antipsychotic therapy during early and late pregnancy: a systematic review. Schizophr Bull 36(3):518–544

    Article  PubMed  Google Scholar 

  • Gentile S, Tofani S, Bellantuono C (2011) Aripiprazole and pregnancy: a case report and literature review. J Clin Psychopharmacol 31(4):531–532, Review

    Article  PubMed  Google Scholar 

  • Gidai J, Acs N, Bánhidy F, Czeizel AE (2008a) No association found between use of very large doses of diazepam by 112 pregnant women for a suicide attempt and congenital abnormalities in their offspring. Toxicol Ind Health 24(1–2):29–39

    Article  PubMed  CAS  Google Scholar 

  • Gidai J, Acs N, Bánhidy F, Czeizel AE (2008b) An evaluation of data for 10 children born to mothers who attempted suicide by taking large doses of alprazolam during pregnancy. Toxicol Ind Health 24(1–2):53–60

    Article  PubMed  CAS  Google Scholar 

  • Gidai J, Acs N, Bánhidy F, Czeizel AE (2008c) A study of the effects of large doses of medazepam used for self-poisoning in 10 pregnant women on fetal development. Toxicol Ind Health 24(1–2):61–68

    Article  PubMed  CAS  Google Scholar 

  • Godet PF, Marie-Cardine M (1991) Neuroleptics, schizophrenia, and pregnancy. Epidemiological and teratologic study. Encéphale 7:543–547

    Google Scholar 

  • Goldstein DJ, Corbin LA, Sundell KL (1997) Effects of first-trimester fluoxetine exposure on the newborn. Obstet Gynecol 89:713–718

    Article  PubMed  CAS  Google Scholar 

  • Goldstein DJ, Corbis LA, Fung MC (2000) Olanzapine-exposed pregnancies and lactation: early experience. J Clin Psychopharmacol 20:399–403

    Article  PubMed  CAS  Google Scholar 

  • Grover S, Gupta N (2005) Lithium associated anencephaly. Can J Psychiatry 50:185–186

    PubMed  Google Scholar 

  • Grover S, Avasthi A, Sharma Y (2006) Psychotropics in pregnancy: weighing the risks. Indian J Med Res 123:497–512

    PubMed  Google Scholar 

  • Gupta N, Grover S (2004) Safety of clozapine in 2 successive pregnancies [letter]. Can J Psychiatry 49:863

    PubMed  Google Scholar 

  • Hanson JW, Oakley GP (1975) Haloperidol and limb deformity [letter]. JAMA 321:26

    Article  Google Scholar 

  • Harden CL, Meador KJ, Pennell PB, Hauser WA, Gronseth GS, French JA, Wiebe S, Thurman D, Koppel BS, Kaplan PW, Robinson JN, Hopp J, Ting TY, Gidal B, Hovinga CA, Wilner AN, Vazquez B, Holmes L, Krumholz A, Finnell R, Hirtz D, Le Guen C (2009a) American Academy of Neurology; American Epilepsy Society. Epilepsia 50(5):1237–1246, Review

    Article  PubMed  Google Scholar 

  • Harden CL, Meador KJ, Pennell PB, Hauser WA, Gronseth GS, French JA, Wiebe S, Thurman D, Koppel BS, Kaplan PW, Robinson JN, Hopp J, Ting TY, Gidal B, Hovinga CA, Wilner AN, Vazquez B, Holmes L, Krumholz A, Finnell R, Hirtz D, Hirtz D, Le Guen C, American Academy of Neurology; American Epilepsy Society (2009) Practice parameter update: management issues for women with epilepsy–focus on pregnancy (an evidence-based review): teratogenesis and perinatal outcomes: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology 73(2):133–141

    Article  PubMed  CAS  Google Scholar 

  • Harden CL, Meador KJ, Pennell PB, Hauser WA, Gronseth GS, French JA, Wiebe S, Thurman D, Koppel BS, Kaplan PW, Robinson JN, Hopp J, Ting TY, Gidal B, Hovinga CA, Wilner AN, Vazquez B, Holmes L, Krumholz A, Finnell R, Hirtz D, Le Guen C (2009c) American Academy of Neurology; American Epilepsy Society. Neurology. 73(2):133–141

    Google Scholar 

  • Hendrick V, Smith LM, Suri R (2003) Birth outcomes after prenatal exposure to antidepressant medication. Am J Obstet Gynecol 188:812–815

    Article  PubMed  CAS  Google Scholar 

  • Holmes LB, Mittendorf R, Shen A, Smith CR, Hernandez-Diaz S (2011) Fetal effects of anticonvulsant polytherapies: different risks from different drug combinations. Arch Neurol 68(10):1275–1281

    Article  PubMed  Google Scholar 

  • Hudak ML, Tan RC (2012) The Committee on drugs: the committee on fetus and newborn. Neonatal Drug Withdrawal. Pediatrics 129(2):540–560

    Article  Google Scholar 

  • Jacobson SJ, Jones K, Johnson K, Ceolin L, Kaur P, Sahn D et al (1992) Prospective multicentric study of pregnancy outcome after lithium exposure during first trimester. Lancet 339:530–533

    Article  PubMed  CAS  Google Scholar 

  • Risperdal (risperidone) Janssen, LP prescribing information. Accessed December 1, 2005.

    Google Scholar 

  • Jentink J, Loane MA, Morris JK, Wellesley D, Garne E, de Jong-van den Berg L, for the EUROCAT Antiepileptic Study Working Group (2010a) Intrauterine exposure to carbamazepine and specific congenital malformations: systematic review and case-control study. BMJ 341:581–609, Review

    Article  Google Scholar 

  • Jentink J, Loane MA, Dolk H, Barisic I, Garne E, Morris JK, den Berg LT De Jong-van, EUROCAT Antiepileptic Study Working Group (2010b) Valproic acid monotherapy in pregnancy and major congenital malformations. N Engl J Med 362(23):2185–2193, Review

    Article  PubMed  CAS  Google Scholar 

  • Källén B (2004) Neonate characteristics after maternal use of antidepressants in late pregnancy. Arch Pediatr Adolesc Med 158(4):312–316

    Article  PubMed  Google Scholar 

  • Källén B, Otterblad-Olausson P (2008) Maternal use of selective serotonin re-uptake inhibitors and persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf 17(8):801–806

    Article  PubMed  Google Scholar 

  • Kantola-Sorsa E, Gaily E, Isoaho M, Korkman M (2007) Neuropsychological outcomes in children of mothers with epilepsy. J Int Neuropsychol Soc 13(4):642–652

    Article  PubMed  Google Scholar 

  • Karakula H, Szajer K, Śpila B, Gryza A, Guy A, Przywara G (2004) Clozapine and pregnancy. A case history. Pharmacopsychiatry 37:303–304

    Article  PubMed  CAS  Google Scholar 

  • Kauppi A, Kumpulainen K, Vanamo T, Merikanto J, Karkola K (2008) Maternal depression and filicide-case study of ten mothers. Arch Womens Ment Health 11(3):201–206

    Article  PubMed  Google Scholar 

  • Kauppi A, Kumpulainen K, Karkola K, Vanamo T, Merikanto J (2010) Maternal and paternal filicides: a retrospective review of filicides in Finland. J Am Acad Psychiatry Law 38(2):229–238

    PubMed  Google Scholar 

  • Klier CM, Mossaheb N, Saria A, Schloegelhofer M, Zernig G (2007) Pharmacokinetics and elimination of quetiapine, venlafaxine, and trazodone during pregnancy and postpartum. J Clin Psychopharmacol 27(6):720–722

    Article  PubMed  Google Scholar 

  • Klys M, Rojek S, Rzepecka-Woźniak E (2007) Neonatal death following clozapine self-poisoning in late pregnancy. An unusual case-report. Forensic Sci Int 171:e5–e10

    Article  PubMed  Google Scholar 

  • Kopelman R, Stuart S (2005) Psychological treatments for postpartum depression. Psychiatr Ann 35:556–566

    Google Scholar 

  • Kruninger U, Meltzer V, Hiemke C, Herpich S (2007) Pregnancy and lactation under treatment with quetiapine. Psychiatr Prax 34(suppl):75–76

    Article  Google Scholar 

  • Kulaga S, Sheehy O, Zargarzadeh AH, Moussally K, Bérard A (2011) Antiepileptic drug use during pregnancy: perinatal outcomes. Seizure 20(9):667–672

    Article  PubMed  Google Scholar 

  • Kulin NA, Pastuszak A, Sage SR et al (1998a) Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study. JAMA 279:609–610

    Article  PubMed  CAS  Google Scholar 

  • Kulin NA, Pastuszak A, Sage SR (1998b) Pregnancy outcome following maternal use of the new selective serotonin reuptake inhibitors: a prospective controlled multicenter study. JAMA 279(8):609–610

    Article  PubMed  CAS  Google Scholar 

  • Laegreid L, Hagberg G, Lundberg A (1992) The effect of benzodiazepines on the fetus and the newborn. Neuropediatrics 23(1):18–23

    Article  PubMed  CAS  Google Scholar 

  • Leppée M, Culig J, Eric M, Sijanovic S (2010) The effects of benzodiazepines in pregnancy. Acta Neurol Belg 110(2):163–167

    PubMed  Google Scholar 

  • Levinson-Castiel R, Merlob P, Linder N (2006) Neonatal abstinence syndrome after in utero exposure to selective serotonin reuptake inhibitors in term infants. Arch Pediatr Adolesc Med 160:173–176

    Article  PubMed  Google Scholar 

  • Liporace JD, Pennell PB, Privitera M, Loring DW (2011a) NEAD Study Group. Foetal antiepileptic drug exposure and verbal versus non-verbal abilities at three years of age. Brain 134(Pt 2):396–404

    PubMed  Google Scholar 

  • Liporace JD, Pennell PB, Privitera M, Loring DW (2011b) Fetal antiepileptic drug exposure: motor, adaptive, and emotional/behavioral functioning at age 3 years. Epilepsy Behav 22(2):240–246

    Article  PubMed  Google Scholar 

  • Livezey GT, Rayburn WF (1992) Principles of perinatal pharmacology. In: Rayburn WF, Zuspann FP (eds) Drug therapy in obstetrics and gynecology, 3rd edn. St. Louis, Mosby-Year Book, Inc, pp 12–1992

    Google Scholar 

  • Llewellyn A, Stowe Z, Strader JR (1998) The use of lithium and management of women with bipolar disorder during pregnancy and lactation. J Clin Psychiatry 59(Suppl 6):57–64

    PubMed  CAS  Google Scholar 

  • Louik C, Lin AE, Werler MM (2007) First-trimester use of selective serotonin-reuptake inhibitors and the risk of birth defects. N Engl J Med 356:2675–2683

    Article  PubMed  CAS  Google Scholar 

  • Lutz UC, Hiemke C, Wiatr G, Farger G, Arand J, Wildgruber D (2010) Aripiprazole in pregnancy and lactation: a case report. J Clin Psychopharmacol 30(2):204–205

    Article  PubMed  Google Scholar 

  • Madadi P, Ito S (2010) Perinatal exposure to maternal lamotrigine: clinical considerations for the mother and child. Can Fam Physician 56(11 ):1132–1134

    PubMed  Google Scholar 

  • Malm H, Klaukka T, Neuvonen PJ (2005) Risks associated with selective serotonin reuptake inhibitors in pregnancy. Obstet Gynecol 106(6):1289–1296

    Article  PubMed  CAS  Google Scholar 

  • Marinucci L, Balloni S, Carinci F, Locci P, Pezzetti F, Bodo M (2011) Diazepam effects on non-syndromic cleft lip with or without palate: epidemiological studies, clinical findings, genes and extracellular matrix. Expert Opin Drug Saf 10(1):23–33, Review

    Article  PubMed  CAS  Google Scholar 

  • McElhatton PR (1994) The effects of benzodiazepine use during pregnancy and lactation. Reprod Toxicol 8(6):461–475

    Article  PubMed  CAS  Google Scholar 

  • McElhatton PR, Garbis HM, Elefant E (1996) The outcome of pregnancy in 689 women exposed to therapeutic doses of antidepressants. A collaborative study of the European Network of Teratology Information Services (ENTIS). Reprod Toxicol 10:285–294

    Article  PubMed  CAS  Google Scholar 

  • McKenna K, Koren G, Tetelbaum M (2005) Pregnancy outcome of women using atypical antipsychotic drugs: a prospective comparative study. J Clin Psychiatry 66(4):444–9

    Article  PubMed  CAS  Google Scholar 

  • Meador KJ, Baker GA, Browning N, Cohen MJ, Clayton-Smith J, Kalayjian LA, Kanner A (2005) Antipsychotic drugs: a prospective comparative study. J Clin Psychiatry 66:444–449

    Article  Google Scholar 

  • Meador KJ, Penovich P (2008) What is the risk of orofacial clefts from lamotrigine exposure during pregnancy? Neurology 71(10):706–707

    Article  PubMed  Google Scholar 

  • Meador KJ, Baker GA, Browning N, Cohen MJ, ClaytonSmith J, Kalayjian LA, Kanner A, Liporace JD, Pennell PB, Privitera M, Loring DW, NEAD Study Group (2011) Foetal antiepileptic drug exposure and verbal versus non-verbal abilities at three years of age. Brain 134:396–404

    Article  PubMed  Google Scholar 

  • Mendhekar DN, Sharma JB, Srivastava PK (2003) Clozapine and pregnancy [letter]. J Clin Psychiatry 64:850

    Article  PubMed  CAS  Google Scholar 

  • Mendhekar DN, Sunder KR, Andrade C (2006a) Aripiprazole use in a pregnant schizoaffective woman. Bipolar Disord 8:299–300

    Article  PubMed  CAS  Google Scholar 

  • Mendhekar DN, Sharma JB, Srilakshmi P (2006b) Use of aripiprazole during late pregnancy in a woman with psychotic illness [letter]. Ann Pharmacother 40:575

    Article  PubMed  CAS  Google Scholar 

  • Merlob P, Mor N, Litwin A (1992) Transient hepatic dysfunction in an infant of an epileptic mother treated with carbamazepine during pregnancy and breastfeeding. Ann Pharmacother 26:1563–1565

    PubMed  CAS  Google Scholar 

  • Mervak B, Collins J, Valenstein M (2008) Case report of aripiprazole usage during pregnancy. Arch Womens Ment Health 11(3):249–250

    Article  PubMed  Google Scholar 

  • Milkovich L, van den Berg BJ (1976) An evaluation of the teratogenicity of certain antinauseant drugs. Am J Obstet Gynecol 125:244–248

    PubMed  CAS  Google Scholar 

  • Misri S, Sivertz K (1991) Tricyclic drugs in pregnancy and lactation: a preliminary report. Int J Psychiatry Med 21(2):157–171

    Article  PubMed  CAS  Google Scholar 

  • Mohan MS, Patole SK, Whitehall JS (2000) Severe hypothermia in a neonate following antenatal exposure to haloperidol [letter]. J Paediatr Child Health 36:412

    Article  PubMed  CAS  Google Scholar 

  • Morrow J, Russell A, Guthrie E, Parsons L, Robertson I, Waddell R, Irwin B, McGivern RC, Morrison PJ, Craig J (2006) Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register. J Neurol Neurosurg Psychiatry 77(2):193–198

    Article  PubMed  CAS  Google Scholar 

  • Morrow JI, Hunt SJ, Russell AJ, Smithson WH, Parsons L, Robertson I, Waddell R, Irwin B, Morrison PJ, Craig JJ (2009) Folic acid use and major congenital malformations in offspring of women with epilepsy: a prospective study from the UK Epilepsy and Pregnancy Register. J Neurol Neurosurg Psychiatry 80(5):506–511

    Article  PubMed  CAS  Google Scholar 

  • Newport DJ, Pennell PB, Calamaras MR, Ritchie JC, Newman M, Knight B, Viguera AC, Liporace J, Stowe ZN (2008) Lamotrigine in breast milk and nursing infants: determination of exposure. Pediatrics 122(1):223–231

    Article  Google Scholar 

  • Nguyen T, Teoh S, Hackett LP, Ilett K (2011) Placental transfer of aripiprazole. Aust N Z J Psychiatry 45(6):500–501

    Article  PubMed  Google Scholar 

  • Nora JJ, Nora AH, Toews WH (1974) Lithium, Ebstein’s anomaly and other congenital heart defects. Lancet 2:594–595

    Article  PubMed  CAS  Google Scholar 

  • Nulman I, Rovet J, Stewart DE, Wolpin J, Gardner HA, Theis JG, Kulin N, Koren G (1997) Neurodevelopment of children exposed in utero to antidepressant drugs. N Engl J Med 336(4):258–262

    Article  PubMed  CAS  Google Scholar 

  • O’Brien Bar-Oz B, Einarson T, Einarson A (2008) Paroxetine and congenital malformations: meta-analysis and consideration of potential confounding factors. Clin Ther 29(5):918–926

    Article  CAS  Google Scholar 

  • O’Collins K, Comer JB (2003) Maternal haloperidol therapy associated with dyskinesia in a newborn. Am J Health Syst Pharm 60:2253–2255

    Google Scholar 

  • Oberlander TF, Warburton W, Misri S, Riggs W, Aghajanian J, Hertzman C (2008) Major congenital malformations following prenatal exposure to serotonin reuptake inhibitors and benzodiazepines using population-based health data. Birth Defects Res B Dev Repord Toxicol 83(1):68–76

    Article  CAS  Google Scholar 

  • Pace A, D’Agostino F (2003) Quetiapine in pregnancy: a case report [in Italian]. Giorn It Ost Ginecol 25:381–385

    Google Scholar 

  • Palac S, Meador KJ (2011) Antiepileptic drugs and neurodevelopment: an update. Curr Neurol Neurosci Rep 11(4):423–427, Review

    Article  PubMed  CAS  Google Scholar 

  • Pariante CM, Seneviratne G, Howard L (2011) Should we stop using tricyclic antidepressants in pregnancy? Psychol Med 41(1):15–17, Review

    Article  PubMed  CAS  Google Scholar 

  • Pastuszak A, Schick-Boschetto B, Zuber C (1993) Pregnancy outcome following first-trimester exposure to fluoxetine (Prozac). JAMA 269:2246–2248

    Article  PubMed  CAS  Google Scholar 

  • Patil AS, Kuller JA, Rhee EH (2011) Antidepressants in pregnancy: a review of commonly prescribed medications. Obstet Gynecol Surv 66(12):777–787

    Article  PubMed  Google Scholar 

  • Pawluski JL (2011). Perinatal Selective Serotonin Reuptake Inhibitor Exposure: Impact on Brain Development and Neural Plasticity. Neuroendocrinology. (Epub ahead of print)

    Google Scholar 

  • Pearlstein T (2008) Perinatal depression: treatment options and dilemmas. J Psychiatry Neurosci 33(4):302–318, Review

    PubMed  Google Scholar 

  • Peitl MV, Petric D, Peitl V (2010) Ziprasidone as possible cause of cleft palate in the newborn. Psychiatr Danub 22(11):117–119

    PubMed  Google Scholar 

  • Pohl-Guimaraes F, Krahe TE, Medina AE (2011) Early valproic acid exposure alters functional organization in the primary visual cortex. Exp Neurol 228(1):138–148

    Article  PubMed  CAS  Google Scholar 

  • Rampono J, Simmer K, Ilett KF, Hackett LP, Doherty DA, Elliot R, Kok CH, Coenen A, Forman T (2009) Placental transfer of SSRI and SNRI antidepressants and effects on the neonate. Pharmacopsychiatry 42(3):95–100

    Article  PubMed  CAS  Google Scholar 

  • Rawlings WJ, Ferguson R, Madison TG (1963) Phenmetrazine and trifluoperazine [letter]. Med J Aust 1:370

    Google Scholar 

  • Reis M, Källén B (2010) Delivery outcome after maternal use of antidepressant drugs in pregnancy: an update using Swedish data. Psychol Med 40(10):1723–1733

    Article  PubMed  CAS  Google Scholar 

  • Rochow N, Küster H, Bandt C, Hoffmann U, Fusch C (2008) Case 1: unexpected muscular hypotonia and need for mechanical ventilation in a preterm infant. Prolonged effect of diazepam. Acta Paediatr 97(12):1602–1603

    Article  PubMed  Google Scholar 

  • Rosenberg L, Mitchell AA, Parsells JL, Pashayan H, Louik C, Shapiro S (1983) Lack of relation of oral clefts to diazepam use during pregnancy. N Engl J Med 309(21):1282–1285

    Article  PubMed  CAS  Google Scholar 

  • Rumeau-Roquette C, Goujard J, Huel G (1975) Possible teratogenic effect of phenothiazines in humans beings. Teratology 15:57–64

    Article  Google Scholar 

  • Safra MJ, Oakeley GP (1975) Association between cleft lip with or without cleft palate and prenatal exposure to diazepam. Lancet 2(7933):478–480

    Article  PubMed  CAS  Google Scholar 

  • Safra MJ, Oakley GP Jr (1976a) Valium: an oral cleft teratogen? Cleft Palate J 13:198–200

    PubMed  CAS  Google Scholar 

  • Safra MJ, Oakley GP Jr (1976b) Association between cleft lip with or without cleft palate and prenatal exposure to diazepam. Lancet 2(7933):478–480

    Google Scholar 

  • Sanz EJ, De-las-Cuevas C, Kiuru A, Bate A, Edwards R (2005) Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet 365(9458):482–487

    PubMed  CAS  Google Scholar 

  • Sawada Feldman H, Lyons Jones K, Lindsay S, Slymen D, Klonoff-Cohen H, Kao K, Rao S, Scokel PW, Jones WN (1962) Infant jaundice after phenothiazine drugs for labor: an enigma. Obstet Gynecol 20:124–127

    Article  Google Scholar 

  • Schou M (1976a) Lithium treatment during pregnancy, delivery, and lactation: an update. J Clin Psychiatry 51:410–413

    Google Scholar 

  • Schou M (1976b) What happened later to the lithium babies? A follow-up study of children born without malformations. Acta Psychiatr Scand 54:193–1927

    Article  PubMed  CAS  Google Scholar 

  • Seay PH, Field WE (1968) Toxicological studies on haloperidol. Int J Neuropsychiatry 3(suppl):1–4

    Google Scholar 

  • Sexson WR, Barak Y (1989) Withdrawal emergent syndrome in an infant associated with maternal haloperidol therapy. J Perinatol 9:170–172

    PubMed  CAS  Google Scholar 

  • Shallcross R, Bromley RL, Irwin B, Bonnett LJ, Morrow J, Baker GA, Liverpool Manchester Neurodevelopment Group, UK Epilepsy and Pregnancy Register (2011) Child development following in utero exposure: levetiracetam vs sodium valproate. Neurology 76(4):383–389

    Article  PubMed  CAS  Google Scholar 

  • Simon GE, Cunningham ML, Davis RL (2002) Outcomes of prenatal antidepressant exposure. Am J Psychiatry 159(12):2055–2061

    Article  PubMed  Google Scholar 

  • Sivojelezova A, Shuhaiber S, Sarkissian L (2005) Citalopram use in pregnancy: prospective comparative evaluation of pregnancy and fetal outcome. Am J Obstet Gynecol 193:2004–2009

    Article  PubMed  CAS  Google Scholar 

  • Slone D, Siskind V, Heinonen OP, Monson RR, Kauffman DW, Shapiro S (1977a) Antenatal exposure to phenothiazines in relation to congenital malformations, perinatal mortality rate, birth weight, and intelligence quotient score. Am J Obstet Gynecol 128:486–488

    PubMed  CAS  Google Scholar 

  • Slone D, Siskind V, Heinonen OP, Monson RR, Kauffman DW, Shapiro S (1977b) Antenatal exposure to phenothiazines in relation to congenital malformations, perinatal mortality rate, birth weight, and intelligence quotient score. Am J Obstet Gynecol 128:486–488

    PubMed  CAS  Google Scholar 

  • Soyka LF, Bigelow SW. Drug metabolizing enzymes and their activity in the human fetus. In: Spryropoulou AC, Zrvas IM, Soldatos CR. Hip dysplasia following a case of olanzapine exposed pregnancy: a questionable association. Arch Womens Ment Health. 9:219–222, 2006.

    Google Scholar 

  • Stahl MM, Lindquist M, Pettersson M (1997) Withdrawal reactions with selective serotonin re-uptake inhibitors as reported to the WHO system. Eur J Clin Pharmacol 53(3–4):163–169

    Article  PubMed  CAS  Google Scholar 

  • Stern L (ed) (1984) Drug use in pregnancy. Adis Health Sciences Press, Sydney, pp 17–44

    Google Scholar 

  • Steiner M, Yonkers KA, Erikson E (2000) Mood disorders in women. Martin Dunitz, London, pp 295–313

    Google Scholar 

  • Stiskal JA, Kulin N, Koren G, Ho T, Ito S (2001) Neonatal paroxetine withdrawal syndrome. Arch Dis Child Fetal Neonatal Ed 84(2):F134–F135

    Article  PubMed  CAS  Google Scholar 

  • Stoner SC, Sommi RW Jr, Marken PA, Anya L, Vaughn J (1997) Clozapine use in two full-term pregnancies [letter]. J Clin Psychiatry 58:364–365

    Article  PubMed  CAS  Google Scholar 

  • Szigethy EM, Wisner KL (2000) Psychopharmacological treatment of mood and anxiety disorders during pregnancy. In: Steiner M, Yonkers KA, Eriksson E (eds) Mood disorders in women. Martin Dunitz Ltd, London, pp 295–313

    Google Scholar 

  • Taylor TM, O’Toole MS, Ohlsen RI, Walters J, Pilousley CS (2003) Safety of quetiapine during pregnancy [letter]. Am J Psychiatry 160:588–589

    Article  PubMed  Google Scholar 

  • Tekin M, Ellison J (2000) Oromandibular-limb hypogenesis spectrum and maternal lithium use. Clin Dysmorphol 9:139–141

    Article  PubMed  CAS  Google Scholar 

  • Tényi T, Trixler M (1998) Clozapine in the treatment of pregnant schizophrenic women [in Hungarian]. Psychiatr Danub 10:15–18

    Google Scholar 

  • Tényi T, Trixler M, Kerestes Z (2002) Quetiapine and pregnancy [letter]. Am J Psychiatry 159:674

    Article  PubMed  Google Scholar 

  • Titze K, Koch S, Helge H, Lehmkuhl U, Rauh H, Steinhausen HC (2008) Prenatal and family risks of children born to mothers with epilepsy: effects on cognitive development. Dev Med Child Neurol 50(2):117–122

    Article  PubMed  Google Scholar 

  • Trenque T, Piednoir D, Frances C, Millart H, Germain ML (2002) Reports of withdrawal syndrome with the use of SSRIs: a case/non-case study in the French pharmacovigilance. Pharmacoepidemiol Drug Saf 11(4):281–283

    Article  PubMed  CAS  Google Scholar 

  • Twaites BR, Wilton LV, Shakir SAW (2007) The safety of quetiapine: results of a post-marketing surveillance study on 1728 patients in England. J Psychopharmacol 21:392–399, database. Pharmacoepidemiol Drug Saf. 11(4):281–283, 2002

    Article  PubMed  Google Scholar 

  • Vajda FJ, Eadie MJ (2005) Maternal valproate dosage and foetal malformations. Acta Neurol Scand 112(3):137–143

    Article  PubMed  CAS  Google Scholar 

  • Vajda FJ, Graham JE, Hitchcock AA, O’Brien TJ, Lander CM, Eadie MJ (2010) Is lamotrigine a significant human teratogen? Observations from the Australian Pregnancy Register. Seizure 19(9):558–561

    Article  PubMed  CAS  Google Scholar 

  • Van Allen MI, Fraser FC, Dallaire L, Allanson J, McLeod DR, Andermann E, Friedman JM (1993) Recommendations on the use of folic acid supplementation to prevent the recurrence of neural tube defects. Clinical Teratology Committee, Canadian College of Medical Geneticists. CMAJ 149(9):1239–1243

    PubMed  Google Scholar 

  • van der Lugt NM, van de Maat JS, van Kamp IL, van der Klein Knoppert EA, Hovens JG, Walther FJ (2012) Fetal, neonatal and developmental outcomes of lithium-exposed pregnancies. Early Hum Dev 88(6):375–378

    Article  PubMed  CAS  Google Scholar 

  • Van Waes A, Van de Velde E (1969) Safety evaluation of haloperidol in the treatment of hyperemesis gravidarum. J Clin Pharmacol 9:224–227

    Article  Google Scholar 

  • Vemuri MP, Rasgon NL (2007) A case of olanzapine-induced gestational diabetes mellitus in the absence of weight gain [letter]. J Clin Psychiatry 68:1989

    Article  PubMed  Google Scholar 

  • Viguera AC, Tondo L, Koukopoulos AE, Reginaldi D, Lepri B, Baldessarini RJ (2011) Episodes of mood disorders in 2,252 pregnancies and postpartum periods. Am J Psychiatry 168(11):1179–1185

    PubMed  Google Scholar 

  • Watanabe N, Kasahara M, Sugibayashi R, Nakamura T, Nakajima K, Watanabe O, Murashima A (2011) Perinatal use of aripiprazole: a case report. J Clin Psychopharmacol 31(3):377–379

    Article  PubMed  Google Scholar 

  • Wadelius M, Darj E, Frenne G, Rane A (1997) Induction fo CYP2D6 in pregnancy. Clin Pharmacol Ther 62:400–407

    Article  PubMed  CAS  Google Scholar 

  • Waldman MD, Safferman A (1993) Pregnancy and clozapine [letter]. Am J Psychiatry 150:168–169

    PubMed  CAS  Google Scholar 

  • Weinstein MR (1976) The international register of lithium babies. Drug Inf J 50:81–86

    Google Scholar 

  • Weinstock L, Cohen LS, Bailey JW, Blatman R, Rosenbaum JF (2001) Obstetrical and neonatal outcome following clonazepam use during pregnancy: a case series. Psychother Psychosom 70(3):158–162

    Article  PubMed  CAS  Google Scholar 

  • Wen SW, Walker M (2004) Risk of fetal exposure to tricyclic antidepressants. J Obstet Gynaecol Can 26(10):887–892

    PubMed  Google Scholar 

  • Wen SW, Yang Q, Garner P (2006) Selective serotonin reuptake inhibitors and adverse pregnancy outcomes. Am J Obstet Gynecol 194:961–966

    Article  PubMed  CAS  Google Scholar 

  • Wide K, Winbladh B, Källén B (2004) Major malformations in infants exposed to antiepileptic drugs in utero, with emphasis on carbamazepine and valproic acid: a nation-wide, population-based register study. Acta Paediatr 93(2):174–176

    Article  PubMed  CAS  Google Scholar 

  • Wikner BN, Källén B (2011) Are hypnotic benzodiazepine receptor agonists teratogenic in humans? J Clin Psychopharmacol 31(3):356–359

    Article  PubMed  CAS  Google Scholar 

  • Wikner BN, Stiller CO, Bergman U, Asker C, Källén B (2007) Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: neonatal outcome and congenital malformations. Pharmacoepidemiol Drug Saf 16(11):1203–1210

    Article  PubMed  Google Scholar 

  • Wilson KL, Zelig CM, Harvey JP, Cunningham BS, Dolinsky BM, Napolitano PG (2011) Persistent pulmonary hypertension of the newborn is associated with mode of delivery and not with maternal use of selective serotonin reuptake inhibitors. Am J Perinatol 28(1):19–24

    Article  PubMed  Google Scholar 

  • Wilton LV, Pearce GL, Martin RM, Mackay FJ, Mann RD (1998) The outcomes of pregnancy in women exposed to newly marketed drugs in general practice in England. Br J Obstet Gynaecol 105(8):882–889

    Article  PubMed  CAS  Google Scholar 

  • Wogelius P, Norgaard M, Gislum M et al (2006) Maternal use of selective serotonin reuptake inhibitors and risk of congenital malformations. Epidemiology 17:701–7044

    Article  PubMed  Google Scholar 

  • Wurst KE, Poole C, Ephross SA, Olshan AF (2010) First trimester paroxetine use and the prevalence of congenital, specifically cardiac, defects: a meta-analysis of epidemiological studies. Birth Defects Res A Clin Mol Teratol 88(3):159–170

    Article  PubMed  CAS  Google Scholar 

  • Wyszynski DF, Nambisan M, Surve T, Alsdorf RM, Smith CR, Holmes LB, Antiepileptic Drug Pregnancy Registry (2005) Increased rate of major malformations in offspring exposed to valproate during pregnancy. Neurology 64(6):961–965

    Article  PubMed  CAS  Google Scholar 

  • Yeshayahu Y (2007) The use of olanzapine in pregnancy and congenital cardiac and musculoskeletal abnormalities [letter]. Am J Psychiatry 164:1759–1769

    Article  PubMed  Google Scholar 

  • Yogev Y, Bem-Haroush A, Kaplan B (2002) Maternal clozapine treatment and decreased fetal hearth rate variability. Int J Gynaecol Obstet 79:259–260

    Article  PubMed  CAS  Google Scholar 

  • Yonkers KA, Little BB, March D (1998) Lithium during pregnancy: drug effects and therapeutic implications. CNS Drugs 4:261–269

    Article  Google Scholar 

  • Zajecka J, Tracy KA, Mitchell S (1997) Discontinuation symptoms after treatment with serotonin reuptake inhibitors: a literature review. J Clin Psychiatry 58(7):291–297

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stephanie Krüger .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Krüger, S. (2013). Psychopharmacological Treatment of Mood and Anxiety Disorders During Pregnancy. In: Regitz-Zagrosek, V. (eds) Sex and Gender Differences in Pharmacology. Handbook of Experimental Pharmacology, vol 214. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30726-3_14

Download citation

Publish with us

Policies and ethics