Citation

Paulzen M, Schoretsanitis G, Nowara VM. Gynakologische Praxis 2022; 50(2): 237-251.

Copyright

(Copyright © 2022)

DOI

unavailable

PMID

unavailable

Abstract

Yes - no - maybe? The uncertainty in answering the question to what extent breastfeeding under psychopharmacotherapy can be recommended is great and the clinical management of psychopharmacotherapy is a great challenge. Due to sparse scientific evidence, the administration of psychotropic drugs must be re-evaluated in each individual case. However, the risk of maternal psychological decompensation is an important factor exerting a negative impact on the mother-child pair, in the worst-case scenario, even suicide or infanticide. Since neither the U.S. Food and Drug Administration (FDA) nor the European Medicines Agency (EMA) has approved a psychotropic drug for use during the breastfeeding period, treatment is always off-label and should therefore only take place after a careful risk assessment and a comprehensive informed consent with detailed documentation. Each therapeutic decision is a case-by-case decision, considering the overall constellation, consisting of psychiatric history, current diagnosis and risk assessment for the infant, ideally with the involvement of a social support network in the mother's and breastfeeding child's environment. Multi-professional support by psychiatrists, pediatricians, gynecologists and midwives should accompany the administration of psychotropic drugs during the breastfeeding period under intensive use of therapeutic drug monitoring (TDM). © 2022 Mediengruppe Oberfranken - Fachverlage GmbH & Co. KG. All rights reserved.

Language: de

Keywords

human; suicide; social support; infanticide; antipsychotics; risk assessment; antidepressants; pediatrician; mother; psychiatrist; informed consent; psychotropic agent; psychopharmacotherapy; medical documentation; breast feeding; drug monitoring; mood stabilizer; Article; medical history; midwife; European Medicines Agency; Food and Drug Administration; therapeutic drug monitoring; breastfeeding; psychopharmaco-therapy