TITLE

Gebelikte Psikotrop İlaç Kullanımı: Bir Güncelleme

AUTHOR(S)
Çetin, Mesut
PUB. DATE
June 2011
SOURCE
Klinik Psikofarmakoloji Bulteni;Jun2011, Vol. 21 Issue 2, p161
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Pregnancy is a turbulent period, during which hormonal and psychosocial lifestyle changes occur. Hence depression, anxiety disorders, or obsessive-compulsive disorders can be triggered and chronic psychiatric disorders can be exacerbated, particularly, due to limitations on the use of psychotropic drugs. Considering a large percentage of pregnancies are not planned, overcoming these challenges creates difficulties for both the pregnant women and the team providing health care services. There are contradictory findings about the safety of psychotropic drugs and their use in the treatment of psychiatric disorders during pregnancy. The benefits and risks of psychopharmacological treatment during pregnancy should be considered carefully. When psychotropic drugs are given to pregnant women they easily reach fetüs, as there are no barriers between maternal and placental blood. Generally higher serum drug levels are detected in newborns than in maternal serum. Therefore in deciding on psychotropic drug use during pregnancy, the risks of neonatal toxicity, premature and still births, and morphological and behavioral teratogenicity must be taken into account. In addition not only anatomical malformations, but also long-term behavioral teratogenicity of the drugs must be considered while evaluating the safety of drug use during pregnancy. The classical antipsychotics and tricyclic antidepressants (except chlomipramine) are relatively safe for the fetus. Antidepressant use is associated with the risk of anomalies during almost all of the prenatal period; however, the risk appears to be especially increased in fetüses that have been exposed to paroxetine and chlomipramine. There are significant findings that many atypical antipschotics cause an increase in the rate of fetal malformations by provoking gestational diabetes. Therefore, women who wish to become pregnant, who have been on ongoing atypical antipsychotic treatment before pregnancy, should always be switched to conventional antipsychotics upon the beginning of pregnancy. Benzodiazepines used during the first trimester can be teratogenic and can cause withdrawal symptoms in high doses in newborns, hypotonia, and agitation. The mood stabilizers (carbamazepine, valproate, similar anticonvulsants, and lithium) have been known to possess high teratogenic risk for a long time. However, the teratogenicity risk for lithium has recently been decreased. On the other hand, the use of valproate during pregnancy has a strong association with the risk of fetal abnormalities and autism-spectrum disorders. For these reasons, the uses of clomipramine, paroxetine, valproate, and atypical antipsychotics are recommended to be avoided during pregnancy. If there is a need for long-term use of psychotropic drugs during pregnancy, a full assessment should be conducted, polypharmacy and unnecessary medication use should be avoided, and the doses of psychotropic drugs should be kept to a minimum, because there are rarely valid reasons to discontinue medications that are necessary during pregnancy. In this paper, we aimed to update psychotropic drug use during pregnancy, an important and common issue in daily psychiatry practice, in the light of recent data.
ACCESSION #
65053080

 

Related Articles

  • The Influence of Typical and Atypical Neuroleptic Drugs in the Production of Interleukin-2 and Interferon-Gamma in vitro. Rudolf, Sebastian; Peters, Marion; Rothermundt, Matthias; Arolt, Volkert; Kirchner, Holger // Neuropsychobiology;2002, Vol. 46 Issue 4, p180 

    Alterations of cytokine levels represent the most consistent finding from studies concerning the involvement of the immune system in the etiology of schizophrenia. These results have been discussed controversially due to the potential influence of drug treatment on cytokine production and on the...

  • Opioid Maintenance Treatment--A Call for a Joint European Quality Care Approach. Brandt, Laura; Unger, annemarie; Moser, Laura; Fischer, Gabriele; Jagsch, Reinhold // European Addiction Research;Jan2016, Vol. 22 Issue 1, p36 

    Aims: The aim of this exploratory analysis of European Quality Audit of Opioid Treatment data was to identify areas of improvement for current opioid maintenance treatment (OMT) approaches.Methods: Factors facilitating treatment entry, retention and refusal were...

  • Corrected QT Interval Prolongation in Psychopharmacological Treatment and Its Modulation by Genetic Variation. Corponi, Filippo; Fabbri, Chiara; Boriani, Giuseppe; Diemberger, Igor; Albani, Diego; Forloni, Gianluigi; Serretti, Alessandro // Neuropsychobiology;2018/2019, Vol. 77 Issue 2, p67 

    Several antipsychotics and antidepressants have been associated with electrocardiogram alterations, the most clinically relevant of which is the heart rate-corrected QT interval (QTc) prolongation, a risk factor for sudden cardiac death. Genetic variants influence drug-induced QTc prolongation...

  • Ghrelin Plasma Levels during Psychopharmacological Treatment. Himmerich, Hubertus; Fulda, Stephany; Künzel, Heike E.; Pfennig, Andrea; Dzaja, Andrea; Cummings, David E.; Pollmächer, Thomas // Neuropsychobiology;2005, Vol. 52 Issue 1, p11 

    The mechanisms underlying weight gain induced by psychopharmacological agents are poorly understood. Because the recently discovered enteric hormone, ghrelin, stimulates food intake, we hypothesized that increases in circulating ghrelin levels might mediate the weight gain caused by certain...

  • Frequency of and determinants for psychotropic drug use in an institution for the mentally retarded. Linaker, Olav M.; Linaker, O M // British Journal of Psychiatry;Apr90, Vol. 156, p525 

    The frequency of psychotropic and anticonvulsant drug use in 168 institutionalised mentally retarded adults was studied. Use of neuroleptics and anticonvulsants was more frequent and use of hypnotics and antidepressants less frequent than in the general population. Neuroleptics were given to 49%...

  • Early intervention in schizophrenia. Kulhara, Parmanand; Banerjee, Anindya; Dutt, Alakananda // Indian Journal of Psychiatry;2008, Vol. 50 Issue 2, p128 

    The article focuses on early intervention programs in schizophrenia and other psychoses. It mentions that programs is amid preventing conversion to manifested psychosis and phase-specific treatment to reduce development of chronic disabilities. It mentions that cognitive behavior therapy have...

  • Antidepressant use during pregnancy highlighted in study.  // PharmacoEconomics & Outcomes News;2/23/2008, Issue 547, p9 

    The article discusses research being done on the use of antidepressant medications during pregnancy. It references a study by S. E. Andrade et al, published in the February 2008 issue of the "American Journal of Obstetrics and Gynecology." The researchers evaluated data from the databases of...

  • Effects of long-term treatment with antipsychotics on serum leptin levels. Herrán, Andrés; García-Unzueta, María Teresa; Amado, José Antonio; de la Maza, María Teresa; Álvarez, Concepción; Vázquez-Barquero, José Luis; Herrán, A; García-Unzueta, M T; Amado, J A; de La Maza, M T; Alvarez, C; Vázquez-Barquero, J L // British Journal of Psychiatry;Jul2001, Vol. 179, p59 

    Background: Abnormal regulation of the adipocyte-derived hormone leptin could play a role in body weight gain induced by antipsychotics.Aims: To study the effects of long-term antipsychotic treatment on leptin levels in patients with schizophrenia.Method:...

  • Both Serum Brain-Derived Neurotrophic Factor and Interleukin-6 Levels Are Not Associated with Therapeutic Response to Lamotrigine Augmentation Therapy in Treatment-Resistant Depressive Disorder. Kagawa, Shoko; Mihara, Kazuo; Suzuki, Takeshi; Nagai, Goyo; Nakamura, Akifumi; Nemoto, Kenji; Kondo, Tsuyoshi // Neuropsychobiology;Feb2018, Vol. 75 Issue 3, p145 

    Background/Aims: Serum levels of brain-derived neurotrophic factor (BDNF) and interleukin-6 (IL-6) were prospectively monitored in relation with therapeutic response to lamotrigine augmentation therapy in 46 (15 males and 31 females) inpatients with treatment-resistant depressive disorder during...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics