Medications

It is essential that healthcare professionals discuss the risks and benefits of use of medications in pregnancy and during breastfeeding to enable the woman to take an informed decision regarding their treatment.

Please refer to ‘Top tips for GPs on prescribing in the perinatal period’.

General principles of prescribing in the perinatal period:

  • It should not be assumed that it is always better to avoid psychotropic medications

  • Use the lowest effective dose

  • Use the medication which is effective for women and has the lowest known risk to mother and foetus

  • Prescribe the least number of medications as possible

  • Document all decisions

  • Ensure that the mother and partner or family are as involved as possible in all decisions

In discussions about medications include:

  • Woman’s level of distress from untreated symptoms

  • Severity of previous episodes, previous response to treatment and the woman’s preference

  • Potential effects of an untreated mental disorder on the foetus or infant (and the need for prompt treatment)

  • Risks of relapse or discontinuation symptoms from stopping the medication abruptly

  • Background risk of foetal abnormalities for pregnant women without a mental disorder

  • Uncertainty with regards to possible increased risk of harm associated with medications during pregnancy and the postnatal period; include the risk in overdose

  • The possibility that stopping a medication with known risk during pregnancy might not remove the associated risk

  • Where possible, written material (preferably individualised) should be provided to explain the risks

References

Howard et al Lancet series on Perinatal Mental Health: Non-psychotic mental disorders in the perinatal period, 2014

single-professional-s v1
2 2Seas

PATH – PerinAtal menTal Health – is part of the Interreg VA 2Seas programme and receives funding from the European Regional Development Fund.

© 2021 Copyright: Bournemouth University

Skip to content