MS2 09 Pregnancy and Psychotropics (from Bipolar & Depression Treatment lectures)|Optimize your exam success with MS2 09 lecture notes on Pregnancy and Psychotropics from the Bipolar & Depression Treatment series. Gain crucial insights for a comprehensive

MS2 09 Pregnancy and Psychotropics (from Bipolar & Depression Treatment lectures)|Optimize your exam success with MS2 09 lecture notes on Pregnancy and Psychotropics from the Bipolar & Depression Treatment series. Gain crucial insights for a comprehensive Antipsychotics - First Gen (Typical) in Pregnancy Do they increase risk of Teratogenicity wrt Major physical malformations Probably no (Most studies: No) Antipsychotics - Second Gen (Atypical) in Pregnancy Do they increase risk of Teratogenicity wrt Major physical malformations? Likely some risk: some evidence first trimester (T1) exposure does increase major malformns (5.2% abs risk with T1 exposure vs 2.5% no T1 exposure) Benzodiazepines: Do they increase risk of Teratogenicity wrt Major physical malformations Probably not, but if so, probably small abs risk Lithium Teratogenicity ?increased risk of Teratogenicity wrt Major physical malformations A little incr abs risk of congenital abnormalities (7 per 1000) is considered small evidence that lithium causes Ebsteins anomaly is uncertain Valproic acid: ? increased risk of Teratogenicity wrt Major physical malformations Yes, cardiovascular defects, neural tube defects and intellectual disability 1. Symptoms of Poor Neonatal Adaptation 2. Caused by what prenatal medication? 1. Symptoms: usu mild irritability, jitteriness; rarely severe 2. any SSRI in THIRD Trimester Persistent pulmonary hypertension by SSRI exposure to newborn 1. Define 2. When is exposure? Definition: Abnormal development of pulmonary vasculature so that pulmonary vascular resistance remains elevated after birth, resulting in right-to-left shunting of blood leads to hypoxemia Caused by exposure to SSRI in third trimester Persistent Pulmonary Hypertension in newborn - what is cause? Cause: mother takes SSRI in third trimester Risk to the newborn if mother takes SSRI during the third trimester? 1. persistent pulmonary hypertension 2. neonatal adaptation syndrome Which antiepileptic/mood stabilizers is avoided when possible in women of reproductive age because of the high rate of intellectual disability in newborns if taken by the mother during pregnancy? valproic acid A new mother starts antidepressants. She is breast feeding. Should she stop? No. Benefits outweigh risks; Which SSRIs appear to have least risk in patient who is breast feeding? Why? sertraline or paroxetine. They have low/undetectable levels in breast milk;