PMH C MEDICATIONS III CERTIFICATION
ASSESSMENT 2026 VERIFIED ANSWERS
GRADED A+
◉ PMAD tx guidelines (APA & ACOG).
Answer: Mild - moderate:
- psychotherapy first line
- continue meds if needed
Severe/Recurrent
- continue meds
Suicidal/Psychotic
- immediate referral to hospital or psychiatric care provider
- medications
◉ Which medication to choose if no medication history?.
Answer: Sertraline/Zoloft
Well-studied, favorable perinatal safety profile
,◉ Why so much conflicting data on meds in perinatal.
Answer: No randomized, double-blind, placebo-controlled trials
Many studies are retrospective database and case-control studies
- may involve voluntary reporting
- confounds (esp illness exposure)
◉ Confounding variables in assessing risk.
Answer: Other prescription/non-prescription meds
Nutrition
ETOH/cigarettes
Genetics
Obesity
Method of delivery
Environmental toxins
Maternal/paternal age
Length of gestation
Stress
Socioeconomic status
◉ Golden rules of pharmacological tx.
Answer: Keep it simple - monotherapy where possible, don't change
what's working
, Ask about and document all known exposure to
medications/supplements/herbals/OTC
Encourage psychotherapy & social support
◉ Parental concerns around perinatal medication.
Answer: Miscarriage
congenital malformation
preterm delivery / low birth weight
NAS - Neonatal Abstinence/Adaptation Syndrome
PPHN - Persistent Pulmonary Hypertension of the Newborn
Long term neurobehavioural effects
Autism
◉ Risk of miscarriage.
Answer: Not a true risk
When adequate controls are utilized - no increased risk with SSRIs
◉ Risk of congenital abnormalities.
Answer: Not a true risk
SSRIs -> no consistent fetal malformations
General population risk is 3% - SSRIs don't increase this
SSRIs/SNRIs are not teratogenic
ASSESSMENT 2026 VERIFIED ANSWERS
GRADED A+
◉ PMAD tx guidelines (APA & ACOG).
Answer: Mild - moderate:
- psychotherapy first line
- continue meds if needed
Severe/Recurrent
- continue meds
Suicidal/Psychotic
- immediate referral to hospital or psychiatric care provider
- medications
◉ Which medication to choose if no medication history?.
Answer: Sertraline/Zoloft
Well-studied, favorable perinatal safety profile
,◉ Why so much conflicting data on meds in perinatal.
Answer: No randomized, double-blind, placebo-controlled trials
Many studies are retrospective database and case-control studies
- may involve voluntary reporting
- confounds (esp illness exposure)
◉ Confounding variables in assessing risk.
Answer: Other prescription/non-prescription meds
Nutrition
ETOH/cigarettes
Genetics
Obesity
Method of delivery
Environmental toxins
Maternal/paternal age
Length of gestation
Stress
Socioeconomic status
◉ Golden rules of pharmacological tx.
Answer: Keep it simple - monotherapy where possible, don't change
what's working
, Ask about and document all known exposure to
medications/supplements/herbals/OTC
Encourage psychotherapy & social support
◉ Parental concerns around perinatal medication.
Answer: Miscarriage
congenital malformation
preterm delivery / low birth weight
NAS - Neonatal Abstinence/Adaptation Syndrome
PPHN - Persistent Pulmonary Hypertension of the Newborn
Long term neurobehavioural effects
Autism
◉ Risk of miscarriage.
Answer: Not a true risk
When adequate controls are utilized - no increased risk with SSRIs
◉ Risk of congenital abnormalities.
Answer: Not a true risk
SSRIs -> no consistent fetal malformations
General population risk is 3% - SSRIs don't increase this
SSRIs/SNRIs are not teratogenic
