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Citation |
Jones I. Medicine (Abingdon) 2012; 40(12): 654-657. |
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Copyright |
(Copyright © 2012, Medicine Publishing) |
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DOI |
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PMID |
unavailable |
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Abstract |
Perinatal psychiatric disorders are common and can result in significant suffering for women and their families; indeed, suicide is a leading cause of maternal death. The severest form of postpartum mood disorder, postpartum psychosis, follows approximately one in 1000 deliveries. Women with a history of bipolar disorder or who have suffered a previous severe postpartum episode are at a many hundred-fold increased risk, and their identification in the antenatal period is a key aspect of management. Decisions regarding the use of psychotropic medication in pregnancy must be made following a full risk:benefit analysis. Risks of taking many medications remain unknown but include teratogenic effects, withdrawal or toxic symptoms in the newborn and long-term developmental effects. However, these must be balanced against the risks of untreated mental illness and the risk of recurrence from stopping or switching well-established and efficacious medications. More data are clearly needed to inform the difficult choices regarding medication that women with severe mental illness are forced to make in regard to pregnancy. © 2012 Elsevier Ltd. All rights reserved. Language: en |
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Keywords |
human; mental health; bipolar disorder; psychotherapy; psychosis; risk assessment; disease severity; perinatal; postpartum; mood disorder; maternal mortality; pregnancy; review; mental disease; fluoxetine; paroxetine; tricyclic antidepressant agent; venlafaxine; priority journal; cognitive therapy; medical decision making; psychotropic agent; practice guideline; puerperal depression; perinatal period; delivery; postnatal depression; postpartum psychosis; maternal stress; puerperal |